Catheter

ABSTRACT

In some examples, a catheter comprises an inner liner, an outer jacket, and a structural support member positioned between at least a portion of the inner liner and the outer jacket. The inner liner, the outer jacket, and the structural support member define a catheter body that comprises a proximal portion having a first outer diameter, a distal portion having a second outer diameter less than the first outer diameter, the distal portion including a distal end of the catheter body, and a medial portion positioned between the proximal portion and the distal portion, the medial portion tapering from the first outer diameter to the second outer diameter.

This application is a continuation of U.S. application Ser. No.14/725,108, filed on May 29, 2015, and entitled, “CATHETER WITH TAPERINGOUTER DIAMETER,” the entire content of which is incorporated herein byreference.

TECHNICAL FIELD

This disclosure relates to a medical catheter.

BACKGROUND

A medical catheter defining at least one lumen has been proposed for usewith various medical procedures. For example, in some cases, a medicalcatheter may be used to access and treat defects in blood vessels, suchas, but not limited to, lesions or occlusions in blood vessels.

SUMMARY

In some aspects, this disclosures describes examples catheters thatinclude an outer jacket that comprises a first section decreasing indurometer along a length of the first section in a direction towards adistal end of a catheter body, and a second section more distal than thefirst section and including the distal end of the elongated body, thesecond section having a higher durometer than a distal portion of thefirst section. The second section and an inner liner of the catheterbody may define a distal opening of the elongated body configured toresist geometric deformation when the distal end of the catheter body isengaged with a guidewire. This disclosure also describes example methodsof forming catheters and methods of using catheters.

Clause 1: In one example, a catheter includes an elongated bodyextending between a proximal end and a distal end, the elongated bodycomprising an inner liner defining an inner lumen of the elongated body,an outer jacket, and a structural support member positioned between atleast a portion of the inner liner and the outer jacket. The outerjacket comprise a first section decreasing in durometer along a lengthof the first section in a direction towards the distal end of theelongated body, and a second section more distal than the first sectionand including the distal end of the elongated body, the second sectionhaving a higher durometer than a distal portion of the first section.The second section and the inner liner define a distal opening of theelongated body configured to resist geometric deformation when thedistal end of the elongated body is engaged with a guidewire.

Clause 2: In some examples of the catheter of clause 1, the structuralsupport member extends along the first section of the outer jacket anddoes not extend along the second section.

Clause 3: In some examples some examples of the catheter of clause 1 or2, a distal tip of the elongated body including the distal end of theelongated body consists essentially of the inner liner and the outerjacket.

Clause 4: In some examples of the catheter of any of clauses 1-3, thecatheter further comprises a radiopaque marker coupled to the elongatedbody, wherein the elongated body distal to the radiopaque markerconsists essentially of the inner liner and the outer jacket.

Clause 5: In some examples of the catheter of any of clauses 1-4, thefirst section of the outer jacket comprises a first segment having afirst durometer of 72D, a second segment having a second durometer of63D, a third segment having a third durometer of 55D, a fourth segmenthaving a fourth durometer of 40D, a fifth segment having a fifthdurometer of 35D, and a sixth segment having a sixth durometer of 25D.In these examples, the first segment is axially adjacent to the secondsegment, the second segment is axially adjacent to and between the firstand third segments, the third segment is axially adjacent to and betweenthe second and fourth segments, the fourth segment is axially adjacentto and between the third and fifth segments, and the fifth segment isaxially adjacent to and between the fourth and sixth segments. Inaddition, in these examples, the second section of the outer jacket mayhave a seventh durometer greater than 25D.

Clause 6: In some examples of the catheter of clause 5, the seventhdurometer is 55D.

Clause 7: In some examples of the catheter of any of clauses 1-6, thefirst section of the outer jacket comprises a plurality of axiallyadjacent sleeves of decreasing durometer.

Clause 8: In some examples of the catheter of any of clauses 1-7, thefirst section of the outer jacket comprises a plurality of axiallyadjacent sleeves, at least two of the sleeves being made from differentmaterials.

Clause 9: In some examples of the catheter of clause 8, a first sleeveof the first section of the outer jacket is formed from aliphaticpolyamide and a second sleeve of the second section of the outer jacketis formed from polyether block amide.

Clause 10: In some examples of the catheter of any of clauses 1-9, thestructural support member comprises a coil member.

Clause 11: In some examples of the catheter of any of clauses 1-10, thestructural support member comprises a hypotube.

Clause 12: In some examples of the catheter of any of clauses 1-11, thestructural support member comprises a braided member.

Clause 13: In some examples of the catheter of any of clauses 1-12, theelongated body decreases in diameter from the proximal end to the distalend.

Clause 14: In some examples of the catheter of any of clauses 1-13, anouter diameter of the second section of the outer jacket tapers towardsa distal end of the elongated body.

Clause 15: In some examples of the catheter of any of clauses 1-14, thesecond section has a higher durometer than a distal-most segment of thefirst section.

Clause 16: In some examples, a catheter comprises an elongated bodydefining a lumen and extending between a proximal end and a distal end,the elongated body comprising an inner liner defining an inner lumen ofthe elongated body and extending toward the distal end of the elongatedbody, a structural support member, and an outer jacket extending to thedistal end of the elongated body, the structural support member beingpositioned between the inner liner and the outer jacket. The outerjacket comprises a proximal segment at the proximal end of the elongatedbody, a distal segment at a distal end of the elongated body, and amedial segment between the proximal portion and the distal portion, thedistal segment having a durometer greater than a durometer of the medialsegment.

Clause 17: In some examples of the catheter of clause 16, the structuralsupport member is coextensive with the medial segment of the outerjacket and is not coextensive with the distal segment.

Clause 18: In some examples of the catheter of clause 16 or 17, a distalportion of the elongated body including the distal end of the elongatedbody consists essentially of the inner liner and the outer jacket.

Clause 19: In some examples of the catheter of any of clauses 16-18, thecatheter further comprises a radiopaque marker coupled to the elongatedbody, wherein the elongated body distal to the radiopaque markerconsists essentially of the inner liner and the outer jacket.

Clause 20: In some examples of the catheter of any of clauses 16-19, theproximal segment of the outer jacket comprises a plurality of axiallyadjacent sleeves of decreasing durometer.

Clause 21: In some examples of the catheter of any of clauses 16-20, theelongated body decreases in diameter from the proximal end to the distalend.

Clause 22: In some examples of the catheter of any of clauses 16-21, anouter diameter of the distal segment of the outer jacket tapers towardsa distal end of the elongated body.

Clause 23: In some examples, a method comprises introducing a guidewirein a patient and introducing a catheter in the patient over theguidewire. The catheter comprises an elongated body extending between aproximal end and a distal end, the elongated body comprising an innerliner defining an inner lumen of the elongated body and extending to thedistal end of the elongated body, a structural support member, and anouter jacket, the structural support member being positioned between atleast a portion of the inner liner and the outer jacket. The outerjacket comprises a first section decreasing in durometer along a lengthof the first section in a direction towards the distal end of theelongated body and a second section including the distal end of theelongated body, the second section having a higher durometer than adistal portion of the first section. The second section and the innerliner define a distal opening of the elongated member configured toresist geometric deformation when the distal end of the elongated bodyis engaged with the guidewire.

Clause 24: In some examples, the method of clause 23 further comprisesremoving a thrombus with the catheter.

Clause 25: In some examples of the method of clause 24, removing thethrombus comprises aspirating the thrombus with the catheter.

Clause 26: In some examples, the method of any of clauses 23-25 furthercomprises advancing a distal end of the catheter into an intracranialblood vessel.

Clause 27: In some examples, the method of clause 26 further comprisesremoving a thrombus from the intracranial blood vessel with thecatheter.

Clause 28: In some examples, a method comprises forming an elongatedbody of a catheter, the elongated body extending between a proximal endand a distal end, wherein forming the elongated body comprisespositioning a structural support member around at least a portion of aninner liner, the inner liner defining an inner lumen of the elongatedbody, and positioning an outer jacket over the structural support memberand the inner liner. The outer jacket comprises a first sectiondecreasing in durometer along a length of the first section in adirection towards the distal end of the elongated body, and a secondsection more distal than the first section and including the distal endof the elongated body, the second section having a higher durometer thana distal portion of the first section. The second section and the innerliner define a distal opening of the elongated member configured toresist geometric deformation when the distal end of the elongated bodyis engaged with a guidewire.

Clause 29: In some examples of the method of clause 28, positioning theouter jacket over the structural support member and the inner linercomprises positioning a first sleeve corresponding to the first sectionover the structural support member and the inner liner, and positioninga second sleeve corresponding to the second section over the structuralsupport member and the inner liner, distal to the first sleeve.

Clause 30: In some examples, the method of clause 29 further compriseswelding the second sleeve to the first sleeve.

Clause 31: In some examples, a method comprises introducing a guidewirein a patient, and introducing a catheter in the patient over theguidewire, the catheter comprising an elongated body extending between aproximal end and a distal end. The elongated body comprises an innerliner defining an inner lumen of the elongated body and extending towardthe distal end of the elongated body, a structural support member, andan outer jacket, the structural support member being positioned betweenat least a portion of the inner liner and the outer jacket. The outerjacket comprises a first section decreasing in durometer along a lengthof the first section in a direction towards the distal end of theelongated body, and a second section including the distal end of theelongated body, the second section having a higher durometer than adistal portion of the first section, wherein the second section and theinner liner define a distal opening of the elongated member. The methodfurther comprises forming a curve in the guidewire and advancing thecatheter over the curve in the guidewire, the distal opening of thecatheter resisting geometric deformation when the catheter is advancedover the curve to a greater degree than would occur if the secondsection were formed of the material of the distal portion of the firstsection.

Clause 32: In some examples, the method of clause 31 further comprisesaspirating thrombus with the catheter.

Clause 33: In some examples, the method of clause 31 or 32 furthercomprises advancing a distal end of the catheter into an intracranialblood vessel.

Clause 34: In some examples, the method of clause 33 further comprisesremoving thrombus from the intracranial blood vessel with the catheter.

Clause 35: In some examples, in the method of clause 34, removingthrombus from the intracranial blood vessel with the catheter comprisesaspirating the thrombus.

Clause 36: In some examples of the method of any of clauses 31-36, thesecond section has a higher durometer than a distal-most portion of thefirst section.

Clause 37: In some examples, a method comprises providing a catheter,the catheter comprising an elongated body extending between a proximalend and a distal end, the elongated body comprising an inner linerdefining an inner lumen of the elongated body and extending toward thedistal end of the elongated body, a structural support member, and anouter jacket, the structural support member being positioned between atleast a portion of the inner liner and the outer jacket. The outerjacket comprises a first section decreasing in durometer along a lengthof the first section in a direction towards the distal end of theelongated body and a second section including the distal end of theelongated body, the second section having a higher durometer than adistal portion of the first section. The second section and the innerliner define a distal opening of the elongated member. The methodfurther comprises forming a curve in a guidewire and advancing thecatheter over the curve in the guidewire, the distal opening of thecatheter resisting geometric deformation when the catheter is advancedover the curve to a greater degree than would occur if the secondsection were formed of the material of the distal portion of the firstsection.

Clause 38: In some examples of the method of clause 37, the secondsection has a higher durometer than a distal-most portion of the firstsection.

Clause 39: In some examples, a method of forming a catheter comprisespositioning an inner liner over a first portion, a second portion, and athird portion of a mandrel, the first portion having a first diameter,the second portion having a second diameter less than the firstdiameter, and the third portion having a tapering diameter that tapersfrom the first diameter to the second diameter, the third portion beinglocated between the first and second portions; positioning a structuralsupport member over the inner liner, wherein the structural supportmember, prior to being positioned over the inner liner, tapers indiameter along at least a portion of a length of the structural supportmember; and positioning an outer jacket over the structural supportmember.

Clause 40: In some examples of the method of clause 39, positioning theinner liner over the mandrel comprises stretching the inner liner overthe mandrel so that the inner liner substantially conforms to themandrel.

Clause 41: In some examples of the method of clause 39 or 40,positioning the inner liner over the mandrel comprises heat shrinkingthe inner liner onto the mandrel.

Clause 42: In some examples of the method of any of clauses 39-41,positioning the inner liner over the mandrel comprises stretching theinner liner over the mandrel so that the inner liner substantiallyconforms to the mandrel and heat shrinking the inner liner onto themandrel.

Clause 43: In some examples of the method of any of clauses 39-42, themethod includes positioning only one inner liner over the mandrel.

Clause 44: In some examples of the method of clause 43, the inner lineris seamless.

Clause 45: In some examples of the method of any of clauses 39-44, afterthe inner liner is positioned over the mandrel, an inner diameter of theinner liner tapers from the first diameter to the second diameter.

Clause 46: In some examples of the method of any of clauses 39-45, thestructural support member comprises a coil member, and the methodfurther comprises forming the coil member prior to positioning the coilmember over the inner liner, wherein forming the coil member compriseswinding a wire onto a second mandrel into a coil configuration, andheat-setting the wire into the coil configuration, the heat-set wiredefining the coil member.

Clause 47: In some examples of the method of clause 46, positioning thestructural support member over the inner liner comprises positioningonly one coil member over the outer surface of the inner liner beforepositioning the outer jacket over the structural support member

Clause 48: In some examples of the method of clause 47, the only onecoil member is devoid of any joints.

Clause 49: In some examples of the method of any of clauses 39-48, thestructural support member is a single coil member that changes in pitchalong a length of the coil member.

Clause 50: In some examples of the method of any of clauses 39-49, thethird portion of the mandrel has a length of about 2.5 centimeters toabout 7.6 centimeters.

Clause 51: In some examples of the method of any of clauses 39-50, themandrel is formed from polytetrafluoroethylene.

Clause 52: In some examples of the method of any of clauses 39-51, themethod further comprises applying a thermoset adhesive to an outersurface of the inner liner, wherein positioning the structural supportmember over the inner liner comprises positioning the structural supportmember over the outer surface of the inner liner after applying thethermoset adhesive to the outer surface, and curing the thermosetadhesive to adhere the structural support member to the inner liner,wherein positioning the outer jacket over the structural support membercomprises positioning the outer jacket over the structural supportmember after curing the thermoset adhesive.

Clause 53: In some examples of the method of clause 52, the methodfurther comprises heat shrinking the outer jacket over the structuralsupport member and the inner liner, wherein the thermoset adhesive doesnot adhere the outer jacket to the structural support member after theouter jacket is heat shrunk over the structural support member and theinner liner.

Clause 54: In some examples of the method of clause 53, the thermosetadhesive does not melt during the heat shrinking of the outer jacketover the structural support member and the inner liner.

Clause 55: In some examples of the method of clause 52, the thermosetadhesive comprises a urethane adhesive.

Clause 56: In some examples of the method of clause 52, the structuralsupport member is a single coil member, and wherein curing the thermosetadhesive adheres only the single coil member to the inner liner.

Clause 57: In some examples of the method of any of clauses 39-56, themethod further comprises applying a thermoset adhesive to an outersurface of an inner liner to define an adhesive layer having a firstthickness less than or equal to a second thickness of the structuralsupport member, wherein positioning the structural support member overthe inner liner comprises positioning the coil member over the outersurface of the inner liner after applying the thermoset adhesive to theouter surface.

Clause 58: In some examples of the method of any of clauses 39-57,positioning the outer jacket over the structural support membercomprises positioning a plurality of outer jacket segments havingdifferent durometers over the structural support member.

Clause 59: In some examples of the method of any of clauses 39-58,positioning the outer jacket over the structural support membercomprises positioning a plurality of outer jacket segments formed fromdifferent materials over the structural support member.

Clause 60: In some examples of the method of any of clauses 39-59, themethod further comprises positioning a marker band over the inner linerdistal to a distal end of the structural support member.

Clause 61: In some examples of the method of clause 60, the methodfurther comprises positioning a distal outer jacket segment over theinner liner distal to the marker band and the structural support member.

Clause 62: In some examples of the method of any of clauses 39-61, themethod further comprises curing an assembly comprising the inner liner,the structural support member positioned over the inner liner, and theouter jacket.

Clause 63: In some examples of the method of any of clauses 39-62, themethod further comprises forming a catheter, wherein forming thecatheter comprises positioning the inner liner over the first portion,the second portion, and the third portion of the mandrel, positioningthe structural support member over the inner liner, and positioning theouter jacket over the structural support member, and connecting a hub toa proximal end of the catheter, the proximal end of the catheter havinga greater diameter than the distal end of the catheter.

Clause 64: In some examples, a method comprises forming a coil member,the coil member tapering in diameter along at least a portion of alength of the coil member, and forming a catheter that includes the coilmember, wherein forming the catheter comprises positioning an innerliner over a mandrel, the mandrel tapering from a first diameter to asecond diameter less than the first diameter, winding the formed coilmember over the inner liner, and positioning an outer jacket over thecoil member.

Clause 65: In some examples of the method of clause 64, forming the coilmember comprises winding a wire onto a second mandrel into a coilconfiguration, and heat-setting the wire into the coil configuration,the heat-set wire defining the coil member.

Clause 66: In some examples of the method of clause 64 or 65,positioning the coil member over the inner liner comprises positioningonly the coil member over the inner liner before positioning the outerjacket over the structural support member, the coil member being devoidof any joints.

Clause 67: In some examples of the method of any of clauses 64-66,forming the coil member comprises forming the coil member to have achanging a pitch along a length of the coil member.

Clause 68: In some examples of the method of any of clauses 64-67,positioning the inner liner over the mandrel comprises stretching theinner liner over the mandrel so that the inner liner substantiallyconforms to the mandrel, and heat shrinking the inner liner onto themandrel.

Clause 69: In some examples of the method of any of clauses 64-68, theinner liner is seamless.

Clause 70: In some examples of the method of any of clauses 64-69, themethod further comprises applying a thermoset adhesive to an outersurface of an inner liner, wherein positioning the coil member over theinner liner comprises positioning the coil member over the outer surfaceof the inner liner after applying the thermoset adhesive to the outersurface, and curing the thermoset adhesive to adhere the coil member tothe inner liner, wherein positioning the outer jacket over the coilmember comprises positioning the outer jacket over the structuralsupport member after curing the thermoset adhesive.

Clause 71: In some examples, an assembly for forming a cathetercomprises a mandrel comprising a first portion having a first diameter,a second portion having a second diameter less than the first diameter,and a third portion having a tapering diameter that tapers from thefirst diameter to the second diameter, the third portion being locatedbetween the first and second portions; a seamless inner liner positionedover the first portion, the second portion, and the third portion of themandrel and substantially conforming to an outer surface of the mandrel;and a structural support member positioned over the inner liner.

Clause 72: In some examples of the assembly of clause 71, the structuralsupport member is a coil member.

Clause 73: In some examples of the assembly of clause 72, wherein thecoil member is devoid of any joints.

Clause 74: In some examples of the assembly of any of clauses 71-73, themandrel is formed from polytetrafluoroethylene.

Clause 75: In some examples of the assembly of any of clauses 71-74, theassembly further comprises a layer of thermoset adhesive positionedbetween the structural support member and the inner liner, the layerhaving a first thickness less than or equal to a second thickness of thestructural support member.

Clause 76: In some examples of the assembly of any of clauses 71-75, theassembly further comprises an outer jacket positioned over thestructural support member.

Clause 77: In some examples of the assembly of clause 76, the outerjacket comprises a plurality of outer jacket segments formed fromdifferent materials.

Clause 78: In some examples of the assembly of clause 77, the outerjacket comprises a plurality of outer jacket segments having differentdurometers.

Clause 79: In some examples of the assembly of any of clauses 71-78, theassembly further comprises a marker band positioned over the inner linerdistal to a distal end of the structural support member.

Clause 80: In some examples of the assembly of clause 79, the assemblyfurther comprises an outer jacket positioned over the structural supportmember, the outer jacket comprising a distal tip segment positioned overthe inner liner distal to the marker band and the structural supportmember.

Clause 81: In some examples, a catheter comprises an elongated bodycomprising an inner liner defining an inner lumen of the elongated body,an outer jacket, and a coil member positioned between at least a portionof the inner liner and the outer jacket, wherein the coil member isadhered to the inner liner with a thermoset adhesive, and wherein thecoil member and the inner liner are not adhered to the outer jacket.

Clause 82: In some examples of the catheter of clause 81, the thermosetadhesive is not positioned between the coil member and the outer jacket.

Clause 83: In some examples of the catheter of clause 82, substantiallyno adhesive is present between the coil member and the outer jacket.

Clause 84: In some examples of the catheter of clause 82, substantiallyno material is present between the coil member and the outer jacket.

Clause 85: In some examples of the catheter of any of clauses 81-84, thethermoset adhesive comprises a urethane adhesive.

Clause 86: In some examples of the catheter of any of clauses 81-85, theouter jacket comprises a plurality of segments having differentdurometers.

Clause 87: In some examples of the catheter of clause 86, the outerjacket segments are situated longitudinally adjacent to each other.

Clause 88: In some examples of the catheter of any of clauses 81-87, theouter jacket comprises a plurality of segments formed from differentmaterials.

Clause 89: In some examples of the catheter of clause 88, the outerjacket segments are situated longitudinally adjacent to each other.

Clause 90: In some examples of the catheter of any of clauses 81-89, theouter jacket comprises a heat-shrinkable material, the outer jacketbeing heat shrunk over the inner liner and the coil member.

Clause 91: In some examples of the catheter of any of clauses 81-90, theelongated body tapers from at least a proximal portion having a firstouter diameter to a distal portion having a second outer diametersmaller than the first diameter.

Clause 92: In some examples of the catheter of clause 91, the coilmember tapers from a first coil diameter to the second coil diameter.

Clause 93: In some examples of the catheter of clause 91, the firstouter diameter is about 6 French and the second outer diameter is about5 French.

Clause 94: In some examples of the catheter of clause 91, the firstouter diameter is about 4 French and the second outer diameter is about3 French.

Clause 95: In some examples of the catheter of any of clauses 81-94, theelongated body has only one coil member.

Clause 96: In some examples of the catheter of any of clauses 81-95, thecoil member comprises a nickel titanium alloy.

Clause 97: In some examples of the catheter of any of clauses 81-96, theinner liner comprises polytetrafluoroethylene.

Clause 98: In some examples, a catheter comprises an elongated bodycomprising an inner liner defining an inner lumen of the elongated body,an outer jacket, and a coil member positioned between at least a portionof the inner liner and the outer jacket, wherein the coil member isadhered to the inner liner with a thermoset adhesive, and wherein theelongated body is devoid of any adhesive between the coil member and theouter jacket.

Clause 99: In some examples of the catheter of clause 98, the elongatedbody is substantially devoid of any material between the outer surfaceof the coil member and the inner surface of the outer jacket.

Clause 100: In some examples of the catheter of clause 98 or 99, thethermoset adhesive comprises a urethane adhesive.

Clause 101: In some examples of the catheter of any of clauses 98-100,the outer jacket comprises a plurality of segments having differentdurometers.

Clause 102: In some examples of the catheter of clause 101, the outerjacket segments are situated longitudinally adjacent to each other.

Clause 103: In some examples of the catheter of any of clauses 98-102,the outer jacket comprises a plurality of segments formed from differentmaterials.

Clause 104: In some examples of the catheter of clause 103, the outerjacket segments are situated longitudinally adjacent to each other.

Clause 105: In some examples of the catheter of any of clauses 98-104,the elongated body tapers from at least a proximal portion having afirst outer diameter to a distal portion having a second outer diametersmaller than the first diameter.

Clause 106: In some examples of the catheter of clause 105, wherein thecoil member tapers from a first coil diameter to a second coil diameter.

Clause 107: In some examples of the catheter of clause 105, the firstouter diameter is about 6 French and the second outer diameter is about5 French.

Clause 108: In some examples of the catheter of clause 105, the firstouter diameter is about 4 French and the second outer diameter is about3 French.

Clause 109: In some examples of the catheter of any of clauses 98-108,the elongated body has only one coil member.

Clause 110: In some examples, a method comprises applying a thermosetadhesive to an outer surface of an inner liner, positioning a coilmember over the outer surface of the inner liner, curing the thermosetadhesive to adhere the coil member to the inner liner, and, after curingthe thermoset adhesive, positioning an outer jacket directly over thecoil member.

Clause 111: In some examples of the method of clause 110, the methodfurther comprises heat shrinking the outer jacket to the coil member andthe inner liner, wherein the thermoset adhesive does not adhere theouter jacket to the coil member after the outer jacket is heat shrunkover the coil member and the inner liner.

Clause 112: In some examples of the method of clause 111, the thermosetadhesive does not melt during the heat shrinking of the outer jacketover the coil member and the inner liner.

Clause 113: In some examples of the method of any of clauses 110-112,positioning the coil member over the outer surface of the inner linercomprises winding the coil member over the outer surface of the innerliner.

Clause 114: In some examples of the method of any of clauses 110-113,the thermoset adhesive comprises a urethane adhesive.

Clause 115: In some examples of the method of any of clauses 110-114,positioning the outer jacket directly over the coil member comprisespositioning a plurality of outer jacket segments having differentdurometers directly over the coil member.

Clause 116: In some examples of the method of any of clauses 110-115,positioning the outer jacket directly over the coil member comprisespositioning a plurality of outer jacket segments formed from differentmaterials directly over the coil member.

Clause 117: In some examples of the method of clause 116, the methodfurther comprises positioning the outer jacket segments longitudinallyadjacent to each other.

Clause 118: In some examples of the method of any of clauses 110-117,the method further comprises positioning an inner liner over a mandrel,wherein the mandrel tapers from at least a proximal portion having afirst outer diameter to a distal portion having a second outer diametersmaller than the first outer diameter.

Clause 119: In some examples of the method of clause 118, the coilmember tapers from a first coil diameter to a second coil diameter.

Clause 120: In some examples of the method of clause 118, the firstouter diameter is about 6 French and the second outer diameter is about5 French.

Clause 121: In some examples of the method of clause 118, the firstouter diameter is about 4 French and the second outer diameter is about3 French.

Clause 122: In some examples of the method of any of clauses 110-121,the coil member is a single coil member, and wherein curing thethermoset adhesive adheres only the single coil member to the innerliner.

Clause 123: In some examples of the method of any of clauses 110-122,the method further comprises heat-setting the coil member without theinner liner present, wherein positioning the coil member over the outersurface of the inner liner comprises winding the heat-set coil memberonto the outer surface of the inner liner.

Clause 124: In some examples of the method of clause 123, heat-settingthe coil member without the inner liner present comprises heat-settingthe coil member on a coil mandrel.

Clause 125: In some examples of the method of clause 124, furthercomprising removing the heat-set coil member from the coil mandrelbefore winding the removed, heat-set coil member onto the outer surfaceof the inner liner.

Clause 126: In some examples of the method of clause 125, removing theheat-set coil member from the coil mandrel comprises unwinding theheat-set coil member from the coil mandrel and winding the heat-set coilmember onto a reel or bobbin.

Clause 127: In some examples, a catheter comprises an inner linerdefining an inner lumen, an outer jacket, and a structural supportmember positioned between at least a portion of the inner liner and theouter jacket, wherein the inner liner, the outer jacket, and thestructural support member define an elongated body extending between aproximal end and a distal end, the elongated body comprising a proximalportion having a first outer diameter, a distal portion having a secondouter diameter less than the first outer diameter, the distal portionincluding the distal end of the elongated body, and a medial portionpositioned between the proximal portion and the distal portion, themedial portion tapering from the first outer diameter to the secondouter diameter.

Clause 128: In some examples of the catheter of clause 127, the proximalportion includes the proximal end of the elongated body.

Clause 129: In some examples of the catheter of clause 127 or 128, themedial portion has a length of about 2.5 centimeters to about 7.6centimeters.

Clause 130: In some examples of the catheter of any of clauses 127-129,only one structural support member is positioned between the outerjacket and the inner liner.

Clause 131: In some examples of the catheter of clause 130, thestructural support member is a single coil that progressively changes inpitch as it extends distally through the elongated body.

Clause 132: In some examples of the catheter of clause 131, thestructural support member is a single coil that tapers in diameter alongthe medial portion.

Clause 133: In some examples of the catheter of clause 130, thestructural support member is a single coil that tapers in diameter alongthe medial portion.

Clause 134: In some examples of the catheter of clause 133, the singlecoil is devoid of any joints.

Clause 135: In some examples of the catheter of any of clauses 127-134,the catheter has only one inner liner.

Clause 136: In some examples of the catheter of clause 135, the innerliner is seamless.

Clause 137: In some examples of the catheter of clause 135, the innerliner tapers through the medial portion of the elongated body from afirst inner diameter in the proximal portion of the elongated body to asecond inner diameter in the distal portion of the elongated body, thesecond inner diameter being less than the first inner diameter.

Clause 138: In some examples of the catheter of clause 135, an innerdiameter of the inner liner is substantially constant.

Clause 139: In some examples of the catheter of clause 135, the innerliner comprises polytetrafluoroethylene.

Clause 140: In some examples of the catheter of any of clauses 127-139,the outer jacket comprises a plurality of sections having differentdurometers.

Clause 141: In some examples of the catheter of any of clauses 127-140,the outer jacket comprises a plurality of sections formed from differentmaterials.

Clause 142: In some examples of the catheter of any of clauses 127-141,the outer jacket comprises a heat-shrinkable material, the outer jacketbeing heat shrunk over the inner liner and the coil member.

Clause 143: In some examples of the catheter of any of clauses 127-142,at least a part of the proximal portion adjacent to the medial portionhas a constant outer diameter substantially equal to the first outerdiameter.

Clause 144: In some examples of the catheter of any of clauses 127-143,at least a part of the distal portion adjacent to the medial portion hasa constant outer diameter substantially equal to the second outerdiameter.

Clause 145: In some examples of the catheter of any of clauses 127-144,the first diameter is about 6 French and the second diameter is about 5French.

Clause 146: In some examples of the catheter of any of clauses 127-144,the first diameter is about 4 French and the second diameter is about 3French.

Clause 147: In some examples of the catheter of any of clauses 127-146,the elongated body is a unitary body devoid of any joints between theproximal, medial, and distal portions.

Clause 148: In some examples, a catheter comprises a seamless innerliner extending between a proximal end and a distal end, the inner linerdefining an inner lumen, an outer jacket, and a coil member positionedbetween at least a portion of the seamless inner liner and the outerjacket, wherein the seamless inner liner, the outer jacket, and the coilmember define an elongated body tapering from a first outer diameter ata proximal portion to a second outer diameter at a distal portion, thesecond outer diameter being less than the first outer diameter, andwherein the proximal portion includes the proximal end of the seamlessinner liner and the distal portion includes the distal end of theseamless inner liner.

Clause 149: In some examples of the catheter of clause 148, theelongated body further comprises a medial portion positioned between theproximal portion and the distal portion, the medial portion taperingfrom the first diameter to the second diameter.

Clause 150: In some examples of the catheter of clause 149, the coilmember progressively changes in pitch in the medial portion.

Clause 151: In some examples of the catheter of any of clauses 148-150,the proximal and distal portions each have a constant outer diameter.

Clause 152: In some examples of the catheter of any of clauses 148-151,only one coil member is positioned between the outer jacket and theinner liner, the coil member tapering in diameter and devoid of anyjoints.

Clause 153: In some examples of the catheter of clause 152, the coilmember progressively changes in pitch as it extends distally through theelongated body.

Clause 154: In some examples of the catheter of any of clauses 148-153,the seamless inner liner tapers from a first inner diameter in theproximal portion of the elongated body to a second inner diameter in thedistal portion of the elongated body, the second inner diameter beingless than the first inner diameter

Clause 155: In some examples of the catheter of any of clauses 148-154,an inner diameter of the inner liner is substantially constant.

Clause 156: In some examples, a method comprises positioning an innerliner over a mandrel, positioning a structural support member over anouter surface of the inner liner, and positioning an outer jacket overthe structural support member, wherein the inner liner, the outerjacket, and the structural support member define an elongated bodyextending between a proximal end and a distal end, the elongated bodycomprising a proximal portion having a first outer diameter, a distalportion having a second outer diameter less than the first outerdiameter, the distal portion including the distal end of the elongatedbody, and a medial portion positioned between the proximal portion andthe distal portion, the medial portion tapering from the first outerdiameter to the second outer diameter.

Clause 157: In some examples of the method of clause 156, positioningthe inner liner over the mandrel comprises heat shrinking the innerliner onto the mandrel.

Clause 158: In some examples of the method of clause 156 or 157,positioning the inner liner over the mandrel comprises stretching theinner liner over the mandrel so that the inner liner substantiallyconforms to the mandrel.

Clause 159: In some examples of the method of any of clauses 156-158,the mandrel tapers from a third diameter to a fourth diameter, thefourth diameter being less than the third diameter.

Clause 160: In some examples of the method of clause 159, the structuralsupport member tapers from the third diameter to the fourth diameterprior to being positioned over the outer surface of the inner member.

Clause 161: In some examples of the method of any of clauses 156-160,positioning the structural support member over the outer surface of theinner liner comprises winding a coil member over the outer surface ofthe inner liner.

Clause 162: In some examples of the method of any of clauses 156-161,the proximal portion includes the proximal end of the elongated body.

Clause 163: In some examples of the method of any of clauses 156-162,the medial portion has a length of about 2.5 centimeters to about 7.6centimeters.

Clause 164: In some examples of the method of any of clauses 156-163,positioning the structural support member over the outer surface of theinner liner comprises positioning only one structural support memberover the outer surface of the inner liner before positioning the outerjacket over the structural support member.

Clause 165: In some examples of the method of any of clauses 156-164,the structural support member is a single coil that progressivelychanges in pitch as it extends distally through the medial portion ofthe elongated body.

Clause 166: In some examples of the method of clause 165, a first pitchof the single coil in the proximal portion of the elongated body isabout 0.00225 inches (about 0.057 mm), a second pitch of the single coilin the medial portion of the elongated body is about 0.00250 inches(about 0.064 mm), a third pitch of the single coil in the distal portionof the elongated body is 0.0030 inches (about 0.076 mm), and a fourthpitch of the single coil in the distal portion of the elongated body is0.0070 inches (about 0.18 mm).

Clause 167: In some examples of the method of any of clauses 156-166,the structural support member is a single coil member that tapers indiameter along the medial portion prior to being positioned over theouter surface of the inner liner.

Clause 168: In some examples of the method of clause 167, the singlecoil is devoid of any joints.

Clause 169: In some examples of the method of any of clauses 156-168,the structural member comprises a coil member, and the method furthercomprises forming the coil member prior to positioning the coil memberover the inner liner, wherein forming the coil member comprises windinga wire onto a second mandrel into a coil configuration, and heat-settingthe wire into the coil configuration, the heat-set wire defining thecoil member.

Clause 170: In some examples of the method of any of clauses 156-169,the method includes positioning only one inner liner over the mandrel.

Clause 171: In some examples of the method of clause 170, the innerliner is seamless.

Clause 172: In some examples of the method of clause 170, after theinner liner is positioned over the mandrel, the inner liner tapers froma first inner diameter to a second inner diameter, the second innerdiameter being less than the first inner diameter.

Clause 173: In some examples of the method of any of clauses 156-172,positioning the outer jacket over the coil member comprises positioninga plurality of outer jacket segments having different durometers overthe coil member.

Clause 174: In some examples of the method of any of clauses 156-173,positioning the outer jacket over the coil member comprises positioninga plurality of outer jacket segments formed from different materialsover the coil member.

Clause 175: In some examples of the method of any of clauses 156-174,the method further comprises heat shrinking the outer jacket to the coilmember and the inner liner.

Clause 176: In some examples of the method of any of clauses 156-175,the elongated body is a unitary body devoid of any joints between theproximal, medial, and distal portions.

Clause 177: In some examples of the method of any of clauses 156-176,the method further comprises applying a thermoset adhesive to the outersurface of the inner liner prior to positioning the structural supportmember over the outer surface of the inner liner.

Clause 178: In some examples of the method of clause 177, the methodfurther comprises curing the thermoset adhesive prior to positioning theouter jacket over the structural support member.

Clause 179: In some examples of the method of clause 178, the structuralsupport member is a single coil member, and wherein curing the thermosetadhesive adheres only the single coil member to the inner liner.

The details of one or more aspects of the disclosure are set forth inthe accompanying drawings and the description below. Other features,objects, and advantages of the techniques described in this disclosurewill be apparent from the description and drawings, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side elevation view of an example catheter, which includes acatheter body and a hub.

FIG. 2 is a conceptual cross-sectional view of a part of the catheterbody 12 of FIG. 1 including the distal end, where the cross-sectiontaken through a center of the catheter body and along a longitudinalaxis of the catheter body.

FIG. 3 is a conceptual cross-sectional view of the catheter body of FIG.1 taken along line A-A in FIG. 1.

FIG. 4 is a conceptual cross-sectional view of the catheter body of FIG.1 taken along line B-B in FIG. 1.

FIG. 5 is a side elevation view of a part of an example structuralsupport member of the catheter body of FIG. 1.

FIG. 6 is a conceptual side elevation view of an example outer jacketthat includes a plurality of segments.

FIG. 7 is a conceptual cross-sectional view of an example distal-mostportion of the catheter body of FIG. 1, which includes the distal tip ofthe catheter body.

FIGS. 8 and 9 are flow diagrams of example methods of forming thecatheter of FIG. 1.

FIG. 10 is a schematic side elevation view of a mandrel and an innerliner positioned over the mandrel.

FIG. 11 is a schematic side elevation view of an example structuralsupport member positioned over an inner liner.

DETAILED DESCRIPTION

In some embodiments, a medical catheter (“catheter”) described hereinincludes a relatively flexible catheter body that is configured to benavigated through vasculature of a patient, e.g., tortuous vasculaturein a brain of the patient. The catheter body is configured to exhibit arelatively high level of structural integrity while defining athin-walled construction. In this way, the catheter may maintain arelatively low profile (e.g., a relatively small outer diameter), whilestill providing a relatively large inner lumen (also referred to as aworking channel in some examples), through which distal tissue sites maybe accessed, e.g., to deliver a medical device or therapeutic agent, toremove a thrombus or other target from the patient's body, or anycombination thereof.

A relatively small outer diameter catheter body may be easier tonavigate through relatively narrow spaces in the patient's body comparedto a catheter body having a larger outer diameter. In addition, therelatively large inner diameter of the catheter may provide for moreefficient and/or more effective aspiration of thrombus from thevasculature compared to catheter bodies having smaller inner diameters,e.g., due to a larger aspiration force that can be applied to thecatheter, due to the larger catheter inner lumen for receiving thethrombus, or both. In addition to, or instead of, providing benefitswhen used to aspirate a thrombus from the vasculature, the relativelylarge inner diameter for a given outer diameter may accommodate a largerrange of medical devices and a larger range of fluid volumes. Thus, thethin-walled catheter body defining a relatively large inner diameter fora given outer diameter maybe used with a larger range of medicalprocedures.

In some embodiments, the catheter body includes an inner liner, astructural support member, a support layer, and an outer jacket, whichinteract to provide a flexible catheter body with sufficient structuralintegrity (e.g., columnar strength) to permit the catheter body to beadvanced through the vasculature from a pushing force applied to aproximal portion of the catheter body, without buckling or undesirablebending (e.g., kinking) of the catheter body. In some examples, theflexible catheter body is configured to substantially conform to thecurvature of the vasculature. In addition, in some examples, thecatheter body has a columnar strength and flexibility that allow atleast a distal portion of the catheter body to be navigated from afemoral artery, through the aorta of the patient, and into theintracranial vascular system of the patient, e.g., to reach a relativelydistal treatment site, including the middle cerebral artery (MCA), theCircle of Willis, and tissue sites more distal than the MCA and theCircle of Willis. The MCA and, consequently, vasculature distal to theMCA may be relatively difficult to access due to the carotid siphon orvertebral artery anatomy that must be traversed to reach such locations.

In some cases, a clinician may steer a catheter through the vasculatureof a patient by rotating the catheter. A distal portion of the catheterbody leads a proximal portion of the catheter body through thevasculature, and may, therefore, be introduced in the patient while theproximal portion is external to the patient. The clinician may applytorque to the proximal portion of the catheter body (or at least aportion of the catheter body that is more proximal than the distalportion implanted in the patient) in order to rotate the distal portionof the catheter. Some embodiments of the catheter body described hereinare configured to transmit the torque applied to a relatively proximalportion to a relatively distal portion. The catheter body may berelatively resistant to kinking upon rotation of the catheter body fromthe relatively proximal portion of the catheter body. For example, thecatheter body may include a structural support member (e.g., a helicalcoil member or a braided member) and a support layer, which areconfigured to help distribute the torsional forces along the catheterbody.

In some examples, the catheter may be a guide catheter that acts as aconduit to help support a microcatheter. In other examples, the cathetermay be a microcatheter. In either example, the catheter body of thecatheter may define an inner lumen, which may be configured to receiveone or more medical devices, deliver a therapeutic agent to a distaltissue site, remove thrombus (e.g., by aspiration) from the patient'svasculature, and the like or any combination thereof. Exampletherapeutic agents include, but are not limited to, an oxygenated mediumor a pharmaceutical agent, which may be, for example, a vasodilator suchas nifedipine or sodium nitroprusside, or a tissue plasminogen activator(t-PA), which can be used to breakdown blood clots.

In examples in which the inner lumen defined by the catheter body isused to remove thrombus from vasculature, the catheter may be referredto as an aspiration catheter. A vacuum may be applied to a proximal endof the catheter body to draw a thrombus into the inner lumen. Anaspiration catheter may be used in a medical procedure to treat anischemic insult, which may occur due to occlusion of a blood vessel thatdeprives brain tissue of oxygen-carrying blood. In some examples, inaddition to being configured to be navigated to relatively distal tissuesites, an aspiration catheter may also include a distal tipconfiguration that is configured to substantially maintain its shape,even in the presence of the vacuum force applied to the catheter duringthe aspiration process.

The catheters described herein may be advanced to a target locationwithin vasculature of the patient in cooperation with a guidewire, aninner catheter, or both, which may aid in the navigation (e.g., steeringand manipulation) of the catheter through the vasculature. For example,an inner lumen of the catheter body may be configured to receive aguidewire or an inner catheter, such that the catheter body may beguided through vasculature over the guidewire or the inner catheter. Asdescribed in further detail below, in some examples, a distal tip of thecatheter body is configured to resist geometric deformation from forcesapplied to the distal tip by the guidewire or inner catheter. Thisresistance to geometric deformation may help improve the ease with whichthe catheter body may be guided to a relatively distal tissue site,e.g., through relatively tight turns in the vasculature.

Although primarily described as being used to reach relatively distalvasculature sites, the relatively thin-walled and kink resistantcatheters described herein may readily be configured to be used withother target tissue sites. For example, the catheters may be used toaccess tissue sites throughout the coronary and peripheral vasculature,the gastrointestinal tract, the urethra, ureters, Fallopian tubes andother body lumens.

FIG. 1 is a side elevation view of an example catheter 10, whichincludes catheter body 12 and hub 14. Catheter hub 14 is positioned at aproximal end of catheter 10 and defines an opening through which aninner lumen 26 (shown in FIG. 2) of catheter body 12 may be accessedand, in some examples, closed. For example, catheter hub 14 may includea luer connector for connecting to another device, a hemostasis valve,or another mechanism or combination of mechanisms. In some examples,catheter 10 includes strain relief member 11, which may be a part of hub14 or may be separate from hub 14. In other examples, the proximal endof catheter 10 can include another structure in addition or, or insteadof, hub 14.

Catheter body 12 is an elongated body that extends from proximal end 12Ato distal end 12B and defines at least one inner lumen 26 (e.g., oneinner lumen, two inner lumens, or three inner lumens) that terminates atdistal opening 13 defined by catheter body 12. In the example shown inFIG. 1, proximal end 12A of catheter body 12 is received within hub 14and is mechanically connected to hub 14 via an adhesive, welding, oranother suitable technique or combination of techniques. Opening 15defined by hub 14 and located at proximal end 14A of hub 14 is alignedwith the inner lumen of catheter body 12, such that the inner lumen ofcatheter body 12 may be accessed via opening 15.

Catheter body 12 has a suitable length for accessing a target tissuesite within the patient from a vascular access point. The length may bemeasured along longitudinal axis 16 of catheter body 12. The targettissue site may depend on the medical procedure for which catheter 10 isused. For example, if catheter 10 is a distal access catheter used toaccess vasculature in a brain of a patient from a femoral artery accesspoint at the groin of the patient, catheter body 12 may have a length ofabout 129 centimeters (cm) to about 135 cm, such as about 132 cm,although other lengths may be used.

As described in further detail below, catheter body 12 may be used toaccess relatively distal locations in a patient, such as the MCA in abrain of a patient. The MCA, as well as other vasculature in the brainor other relatively distal tissue sites (e.g., relative to the vascularaccess point), may be relatively difficult to reach with a catheter, dueat least in part to the tortuous pathway (e.g., comprising relativelysharp twists and/or turns) through the vasculature to reach these tissuesites. Catheter body 12 may be structurally configured to be relativelyflexible, pushable, and relatively kink- and buckle-resistant, so thatit may resist buckling when a pushing force is applied to a relativelyproximal portion of the catheter to advance the catheter body distallythrough vasculature, and so that it may resist kinking when traversingaround a tight turn in the vasculature. Kinking and/or buckling ofcatheter body 12 may hinder a clinician's efforts to push the catheterbody distally, e.g., past a turn.

One structural characteristic that may contribute to at least thepushability and flexibility of catheter body 12 is the outer diameter ofcatheter body 12, which tapers from a first outer diameter at a proximalportion 17A to a second outer diameter at a distal portion 17B, thesecond outer diameter being smaller than the first outer diameter.Proximal portion 17A may include proximal end 12A and distal portion 17Bmay include distal end 12B. Catheter body 12 may further include amedial portion 17C between proximal portion 17A and distal portion 17B;medial portion 17C may gradually taper in outer diameter from the firstouter diameter to the second outer diameter. Thus, medial portion 17Ccan define a smooth transition from the larger diameter proximal portion17A to the smaller diameter distal portion 17B. In some examples, medialportion 17C continuously tapers (e.g., a linear rate of change in outerdiameter) from the first outer diameter to the second outer diameter. Inother examples, medial portion 17C may taper in a curved manner, e.g.,defining a convex or concave curve, or it may progressively change inouter diameter, e.g., it may define discrete step-downs in outerdiameter to define the taper. The size of the discrete step-downs indiameter may be selected to reduce the number of edges that may catch onanatomical features within the vasculature as catheter body 12 isadvanced through vasculature.

In some examples, at least a part (e.g., only part of the length or theentire length) of proximal portion 17A and/or distal portion 17B has aconstant outer diameter. For example, the constant outer diameter inproximal portion 17A may be just proximal of medial portion 17C and theconstant outer diameter in distal portion 17B may be just distal ofmedial portion.

A larger diameter proximal portion 17A may provide better proximalsupport for catheter body 12, which may help increase the pushability ofcatheter body 12. In contrast, in examples in which a catheter body hasa constant diameter along its entire length, the constant diameter maybe selected to facilitate distal flexibility of the catheter body 12,and, as a result, may be configured with less proximal support thancatheter body 12. Catheter body 12 can have a smaller outer diameter atdistal portion 17B to increase the flexibility of catheter body 12 alongdistal portion 17B, while still maintaining an outer diameter atproximal portion 17A that better facilitates pushability of catheterbody 12.

A catheter having a smaller outer diameter may be easier to navigatethrough tortuous vasculature. Thus, by reducing the outer diameter ofcatheter body 12 at distal portion 17B, which leads catheter body 12through vasculature, catheter body 12 may better traverse throughtortuous vasculature with still maintaining a relatively high level ofproximal pushability. In some cases, proximal portion 17A may not beintroduced into low profile or tortuous arteries, such that thecross-sectional size of proximal portion 17A may be increased in favorof proximal support without adversely affecting the ability of catheterbody 12 to reach relatively distal tissue sites.

In some examples, the first outer diameter is about 6 French (e.g., 6French or nearly 6 French) and the second outer diameter is about 5French (e.g., 5 French or nearly 5 French). In other examples, the firstouter diameter is about 4 French (e.g., 4 French or nearly 4 French) andthe second outer diameter is about 3 French (e.g., 3 French or nearly 3French). The measurement term French, abbreviated Fr or F, is threetimes the diameter of a device as measured in mm. Thus, a 6 Frenchdiameter is about 2 millimeters (mm), a 5 French diameter is about 1.67mm, a 4 French diameter is about 1.33 mm, and a 3 French diameter isabout 1 mm.

The proximal, distal, and medial portions 17A-17C of catheter body 12may each have any suitable length. The working length of catheter body12 may be measured from distal end 14B of hub 14 to distal end 12B ofcatheter body 12. In some examples, the length of proximal portion 17Athat extends from distal end 14B of hub 14 to medial portion 17C isabout 38.16 inches (about 96.93 cm), medial portion 17C has a length ofabout 1 inch (about 2.5 cm) to about 3 inches (about 7.6 cm), such asabout 2 inches (about 5 cm) and distal portion 17B has a length of about11.1 inches (about 30 cm). However, in other examples, proximal, distal,and medial portions 17A-17C may have different lengths.

The length over which catheter body 12 tapers from the first outerdiameter to the second outer diameter, which may be the length of medialportion 17C, may be long enough to provide a relatively smoothtransition between the first and second outer diameters. A relativelyabrupt transition, such as a taper over 0.5 cm or less, may define aledge, which may cause catheter body 12 to catch on certain anatomicalfeatures as it is advanced through vasculature of the patient. This mayadversely affect the navigability of catheter body 12. A relativelyabrupt transition may also cause a greater disturbance in the blood flowaround catheter body 12 when body 12 is positioned in vasculaturecompared to a more gradual taper provided by medial portion 12. The flowdisturbance may be undesirable in some cases.

In some examples, the diameter of inner lumen 26 (shown in FIG. 2) ofcatheter body 12, also referred to herein as an inner diameter ofcatheter body 12, may be substantially constant from proximal end 12A todistal end 12B. In other examples, the inner diameter of catheter body12 may taper from a first inner diameter at a proximal portion thatincludes proximal end 12A to a second inner diameter at a distal portionthat includes distal end 12B, the second inner diameter being smallerthan the first inner diameter. For example, an inner diameter ofcatheter body 12 may taper from a first inner diameter of about 0.0685inches (about 1.74 mm) to a second inner diameter of about to 0.0605inches (about 1.54 mm). The inner diameter may, for example, graduallytaper along the portion of inner lumen 26 extending through medialportion 17C of catheter body 12, where the taper can be linear, curved,continuous or discontinuous; e.g., the inner diameter of catheter body12 may step-down from the first inner diameter to the second innerdiameter in discrete steps.

Catheter body 12 can be relatively thin-walled, such that it defines arelatively large inner diameter for a given outer diameter, which mayfurther contribute to the flexibility and kink-resistance of catheterbody 12. The wall thickness of catheter body 12 may be the differencebetween the outer diameter of catheter body 12 and the inner diameter ofcatheter body 12, as defined by inner lumen 26.

In some examples, rather than being formed from two or more discrete andseparate longitudinally extending segments that are mechanicallyconnected to each other, e.g., at axial butt joints, catheter body 12may be substantially continuous along a length of catheter body 12. Forexample, catheter body 12 may include an inner liner that defines theinner lumen of catheter body 12 and continuously extends from proximalend 12A to distal end 12B of catheter body 12, and a structural supportmember that extends across at least a part of the proximal portion, atleast part of the distal portion, and the medial portion of catheterbody 12. A substantially continuous catheter body 12 may be betterconfigured to better distribute forces in a longitudinal direction (in adirection along longitudinal axis 16) and rotational direction (rotationabout longitudinal axis 16) compared to a catheter body including two ormore longitudinally extending segments that are mechanically connectedto each other. Thus, the substantially continuous construction ofcatheter body 12 may contribute to the ability of body 12 to transferaxial pushing forces from proximal portion 17A of catheter body 12 todistal portion 17B, as well transfer rotational forces (if any) appliedfrom proximal portion 17A of catheter body 12 to distal portion 17B.

While in some examples, as described with reference to FIG. 5, catheterbody 12 includes an outer jacket formed of two or more longitudinallyextending segments that are in an abutting relationship, due to thecontinuous inner liner and the structural support member that extendsalong a majority of the length of catheter body 12, catheter body 12 maystill better distribute forces and flexibility compared to a catheterbody including two or more longitudinal sections that are mechanicallyconnected to each other. The inner liner and/or structural supportmember that extends through at least a part of proximal portion 17A, atleast part of distal portion 17B, and medial portion 17C of catheterbody 12 may provide sufficient continuity to catheter body 12 to provideit with the desired force distribution characteristics for facilitatingpushing of catheter body 12 to relatively distal tissue sites, and forfacilitating rotational movement of catheter body 12.

In some examples, at least a portion of an outer surface of catheterbody 12 includes one or more coatings, such as, but not limited to, ananti-thrombogenic coating, which may help reduce the formation ofthrombi in vitro, an anti-microbial coating, and/or a lubricatingcoating. The lubricating coating may be configured to reduce staticfriction and/kinetic friction between catheter body 12 and tissue of thepatient as catheter body 12 is advanced through the vasculature. Thelubricating coating can be, for example, a hydrophilic coating. In someexamples, the entire working length of catheter body 12 (from distalportion 14B of hub 14 to distal end 12B) is coated with the hydrophiliccoating. In other examples, only a portion of the working length ofcatheter body 12 coated with the hydrophilic coating. This may provide alength of catheter body 12 distal to distal end 14B of hub 14 with whichthe clinician may grip catheter body 12, e.g., to rotate catheter body12 or push catheter body 12 through vasculature.

FIG. 2 is a conceptual cross-sectional view of a part of catheter body12 including distal end 12B, where the cross-section is taken through acenter of catheter body 12 along longitudinal axis 16. FIG. 3 is aconceptual cross-sectional view of catheter body 12 taken along line A-Ain FIG. 1, and FIG. 4 is a conceptual cross-sectional view of catheterbody 12 taken along line B-B in FIG. 1. As shown in FIGS. 2-4, catheterbody 12 includes inner liner 18, structural support member 20, supportlayer 22, and outer jacket 24.

Inner liner 18 defines inner lumen 26 of catheter body 12, inner lumen26 extending from proximal end 12A to distal end 12B and defining apassageway extending from proximal end 12A to distal opening 13 atdistal end 12B of catheter body 12. Inner lumen 26 may be sized toreceive a medical device (e.g., another catheter, a guidewire, anembolic protection device, a stent, or any combination thereof), atherapeutic agent, or the like. At least the inner surface of innerliner 18 defining inner lumen 26 may be lubricious in some examples inorder to facilitate the introduction and passage of a device, atherapeutic agent, or the like, through inner lumen 26. For example, thematerial from which the entire inner liner 18 is formed may belubricious, or inner liner 18 may be formed from two or more materials,where the material that defines inner lumen 26 may be more lubriciousthan the material that interfaces with structural support member 20 andsupport layer 22. In addition to, or instead of, being formed from alubricious material, in some examples, an inner surface of inner liner18 is coated with a lubricious coating.

Example materials from which inner liner 18 may be formed include, butare not limited to, polytetrafluoroethylene (PTFE), fluoropolymer,perfluoroalkyoxy alkane (PFA), fluorinated ethylene propylene (FEP), orany combination thereof. For example, inner liner 18 may be formed froma non-etched PTFE, e.g., may consist essentially of a non-etched PTFE.

In some examples, inner liner 18 is a single, seamless tubular body,such that inner lumen 26 of catheter body 12 is continuous along itsentire length, e.g., from proximal end 12A to distal opening 13. Aseamless inner liner 18 may, for example, be devoid of any seams (e.g.,the seam formed from joining two separate tubular bodies together at anaxial location), such that the seamless inner liner 18 is a unitarybody, rather than multiple, discrete bodies that are separately formedand subsequently connected together. In addition, in some examples,inner liner 18 defines a substantially constant (e.g., identical ornearly identical) inner diameter along the entire length of inner liner18, while in other examples, inner liner 18 may define different innerdiameters. For example, inner liner 18 may define a first inner diameteralong a proximal portion of inner liner 18 and a second inner diameteralong a distal portion of inner liner, the second inner diameter beingsmaller than the first inner diameter. For example, inner liner 18 maytaper continuously from the first inner diameter to the second innerdiameter, or may define one or more step-downs in inner diameter alongthe length of inner liner 18. As another example, as described withreference to FIG. 1, inner liner 18 may have a proximal portion havingthe first inner diameter along proximal portion 17A (FIG. 1) of catheterbody 12, a distal portion having the second inner diameter along distalportion 17B (FIG. 1) of catheter body 12, and a medial portionpositioned between the proximal and distal portions and graduallytapering from the first inner diameter to the second inner diameter.

In some examples in which inner liner 18 defines inner lumen 26 havingdifferent diameters, the wall thickness T (shown in FIGS. 3 and 4) mayvary along the length of catheter body 12. For example, the wallthickness T in proximal portion 17A may be greater than wall thickness Tin distal portion 17B. In other examples, the wall thickness T may besubstantially the same (e.g., identical or nearly identical) along alength of catheter body 12.

A seamless inner liner 18 may be easier to slide over another device,e.g., another catheter or a guidewire, compared to a catheter formedfrom two or more longitudinal sections that are mechanically connectedto each other because the seamless inner liner may define a smootherinner lumen 26. In contrast, joints between sections of an inner linerthat are formed from two or more longitudinal sections may definesurface protrusions or other irregularities along inner lumen 26 whichmay interfere with the passage of devices through inner lumen 26. Inaddition, a seamless inner liner 18 may help distribute pushing androtational forces along the length of catheter body 12. Thus, theseamless inner liner 18 may help contribute to the pushability ofcatheter body 12.

Structural support member 20 is configured to increase the structuralintegrity of catheter body 12 while allowing catheter body 12 to remainrelatively flexible. For example, member 20 may be configured to helpcatheter body 12 substantially maintain its cross-sectional shape or atleast help prevent catheter body 12 from buckling or kinking as it isnavigated through tortuous anatomy. Structural support member 20,together with inner liner 18, support layer 22, and outer jacket 24, mayhelp distribute both pushing and rotational forces along a length ofcatheter body 12, which may help prevent kinking of body 12 uponrotation of body 12 or help prevent buckling of body 12 upon applicationof a pushing force to body 12. As a result, a clinician may applypushing forces, rotational forces, or both, to a proximal portion ofcatheter body 12, and such forces may cause a distal portion of catheterbody 12 to advance distally, rotate, or both, respectively.

In the example shown in FIGS. 1 and 2, structural support member 20extends along only a portion of a length of catheter body 12. Forexample, a proximal end of structural support member 20 may bepositioned distal to distal end 14B of hub 14 (and/or of strain relief11) and a distal end of member 20 be positioned at distal end 12B ofcatheter 12 or proximal to distal end 12B. In other examples, a proximalend of structural support member 20 may be positioned proximal to distalend 14B of hub 14 and a distal end of member 20 be positioned at distalend 12B of catheter 12 or proximal to distal end 12B.

In some examples, structural support member 20 includes a generallytubular braided structure, a coil member defining a plurality of turns,e.g., in the shape of a helix, or a combination of a braided structureand a coil member. Thus, although examples of the disclosure describestructural support member 20 as a coil, in some other examples, thecatheter bodies described herein may include a braided structure insteadof a coil or a braided structure in addition to a coil. For example, aproximal portion of structural support member 20 may include a braidedstructure and a distal portion of structural support member 20 mayinclude a coil member.

Structural support member 20 is coupled, adhered and/or mechanicallyconnected to at least a portion of an outer surface of inner liner 18via support layer 22. For example, support layer 22 may be athermoplastic material or a thermoset material, such as a thermosetpolymer and/or a thermoset adhesive (e.g., a thermoset polyurethaneadhesive, such as Flexobond 430, commercially available from BaconIndustries of Irvine, Calif.). In some cases, the material formingsupport layer 22 may have elastic properties, such that there may be atendency for support layer 22 to a return to a resting position. Thismay be referred to as “bounce back” of support layer 22. A support layer22 formed from a cured thermoset polyurethane adhesive exhibits arelatively delayed bounce back response compared to a thermoplasticmaterial, e.g., due at least in part to the elastic properties of thethermoset polyurethane adhesive. The delayed bounce back response may beadvantageous for navigating catheter body 12 through vasculature. Forexample, the delayed bounce back response may reduce the extent to whichcatheter body 12 may spring against vascular walls as it is advancedthrough the vasculature.

In some examples, support layer 22 is positioned between the entirelength of structural support member 20 and inner liner 18. In otherexamples, support layer 22 is only positioned between a part of thelength of structural support member 20 and inner liner 18.

In some examples, as shown in FIG. 4, support layer 22 may only bepositioned between structural support member 20 and inner liner 18, andsubstantially no support layer 22 material (e.g., no support layermaterial or nearly no support layer material) is positioned betweenstructural support member 20 and outer jacket 24. As a result, supportmember 20 and inner liner 18 are not adhered to outer jacket 24 viasupport layer 22. For example, in some examples, as described in furtherdetail with respect to FIGS. 8 and 9, when support layer 22 comprises athermoset polymer, the polymer may be cured before outer jacket 24 ispositioned over inner liner 18 and structural support member 20. Due tothe relatively high melting temperature of the thermoset polymer, aswell as other properties of the thermoset polymer (compared tothermoplastic materials), outer jacket 24 may be heat shrunk ontostructural support member 20 and support layer 22 without causing thethermoset polymer to melt and reflow. As a result, the relative positionbetween structural support member 20 and inner liner 18 may bemaintained during the one or more manufacturing steps in which outerjacket 24 is mechanically connected to structural support member 20 andsupport layer 22.

The use of a thermoset polymer to mechanically connect structuralsupport member 20 to inner liner 18 may help reduce or minimize theamount of (or eliminate entirely) material between structural supportmember 20 and outer jacket 24, which further contributes to the thinnessof the walls of catheter body 12. For example, outer jacket 24 may beheat shrunk onto structural support member 20 and support layer 22,which may eliminate the need for an adhesive to further mechanicallyconnect outer jacket 24 to structural support member 20 and supportlayer 22. As a result, structural support member 20 and inner liner 18may not be adhered to outer jacket 24. In at least this way, the use ofa thermoset polymer between member 20 and inner liner 18 may helpeliminate an adhesive layer between member 20 and outer jacket 24, whichmay help reduce the wall thickness T (shown in FIGS. 3 and 4) ofcatheter body 12 and, therefore, increase the inner diameter of catheterbody 12 for a given outer diameter.

Reducing the thickness of the catheter body wall may help increase theinner diameter of inner lumen 26 for a given outer diameter of catheterbody 12. As discussed, a larger inner lumen 26 may provide certainbenefits in some examples, such as allowing for more effectiveaspiration of thrombi, for accommodation of a larger range of medicaldevices or easier manipulation of medical devices within inner lumen 26,or both.

In the example shown in FIG. 4, substantially no material (e.g., nomaterial or nearly no material) is present between at least someportions of structural support member 20 and at least some portions ofouter jacket 24, such that at least a portion of member 20 is in directcontact with outer jacket 24. This direct contact may help distributeflexibility from member 20 to outer jacket 24, which may increase thekink resistance of catheter body 12. In some examples, catheter body 12is devoid of any material between an outer surface of structural supportmember 20 (e.g., a coil member) and an inner surface of outer jacket 24,such that the outer surface of member 20 and outer jacket 24 are indirect contact with each other.

In contrast, when a thermoplastic material is used to at least partiallyfill the spaces defined by structural support member 20 and tomechanically connect member 20 to inner liner 18, the thermoplasticmaterial may melt when outer jacket 24 is heat shrunk onto inner liner18 and member 20, which may cause structural support member 20 toundesirably migrate relative to inner liner 18, as well as cause thethermoplastic material to reflow and flow between structural supportmember 20 and outer jacket. While outer jacket 24 may be adhered tomember 20 and support layer 22 in order to avoid this reflow, ratherthan being heat shrunk onto inner liner 18 and member 20, the adhesivemay define an additional layer between member 20 and outer jacket 24,which may increase the wall thickness of catheter body 12. Increasingthe wall thickness of catheter body 12 in this manner may be undesirablein some cases.

In addition to helping to reduce the thickness T of the wall of catheterbody 12, a thermoset polymer may provide better structural integrity tocatheter body 12 compared to a thermoplastic polymer. In contrast someor all thermoplastic polymers, a thermoset polymer may include polymersthat cross-link together during the curing process. This cross-linkingmay provide a particular sample of a thermoset polymer with highertemperature resistance, more flexibility, and more dimensional stabilitycompared to a sample of a thermoplastic material having the samedimensions. The higher flexibility and higher dimensional stability mayhelp achieve the desired structural characteristics for catheter body12, e.g., the desired flexibility, kink-resistance, and pushability. Inaddition, as discussed above, because a thermoset polymer may be moreresistant to high temperatures than a thermoplastic polymer, whensupport layer 22 is formed from a thermoset polymer, support layer 22may remain in a cured state (and not reflow) in the presence of highheat, such as during heat shrinking of outer jacket 24 onto supportlayer 22 and structural support member 20. This may help definestructural support member 20 having the structural features, e.g., thedesired pitch.

Support layer 22 is configured to fill at least part of the spacesbetween portions of structural support member 20, e.g., the spacesbetween turns of structural support member 20 in examples in whichmember 20 is a coil member. The presence of support layer 22 betweenturns of member 20 may help distribute the flexibility provided bymember 20 along the length of member 20, which may help prevent catheterbody 12 from kinking. For example, at least by eliminating voids betweenturns of structural support member 20, support layer 22 may transfer theflexing motion from structural support member 20 along a length ofcatheter body 12.

In some examples, support layer 22 has a thickness (measured in adirection orthogonal to longitudinal axis 16) that is greater than orequal to a cross-sectional dimension of the wire that forms the member20, such that layer 22 is at least partially positioned between outerjacket 24 and structural support member 20.

In other examples, support layer 22 has a thickness that is less than orequal to a cross-sectional dimension of the wire that forms thestructural support member 20. In these examples, support layer 22 is notpositioned between outer jacket 24 and structural support member 20,such that a thickness T (FIGS. 3 and 4) of the wall of catheter body 12is smaller compared to examples in which support layer 22 has athickness that is greater than or equal to a cross-sectional dimensionof the wire that forms the member 20.

In the example shown in FIGS. 2-4, structural support member 20 isformed from a wire, such as a rounded (in cross-section) wire, that isshaped to define a helical coil. In other examples, member 20 may beformed, at least in part, from a flat (in cross-section) wire that isshaped to define a helical coil. A rounded wire may define a coil memberhaving a smaller surface area than a flat wire, such that, for a givenlength of structural support member 20, the rounded wire may be moretightly wound than a flat wire. Because the tightness with which thewire is wound to define the coil member may affect the stiffness of thecoil member, the rounded coil member may allow for the formation of astructural support member 20 having a larger range of stiffness thanthen a flat wire. In this way, a rounded wire may, in some examples,achieve a support member 20 having a more flexible distal portion and astiffer proximal portion than a flat wire.

The wire from which member 20 is formed can be a metal wire. In someexamples, the wire is formed from a shape memory material, such a nickeltitanium alloy (Nitinol). In other examples, the wire is formed fromstainless steel. In some cases, a nickel titanium alloy may be morecrush resistant than stainless steel, and, therefore, may be used toform a structural support member 20 of a catheter that is more resistantto kinking and buckling compared to stainless steel. In addition, asdescribed in further detail below, a shape memory material may allowstructural support member 20 to be formed before it is positioned overinner liner 18. For example, the pitch and diameter of member 20 may bedefined before member 20 is positioned over inner liner 18, which mayprovide certain advantages (discussed below). In contrast, when member20 is formed from stainless steel, the pitch and diameter of member 20may be defined as member 20 is wound over inner liner 18.

The flexibility of structural support member 20, and, therefore, theflexibility of catheter body 12 may be, at least in part, a function ofa pitch of the helical coil defined by structural support member 20. Alarger pitch results in larger gaps between adjacent turns of the wireforming member 20 and a higher degree of flexibility. The pitch can be,for example, the width of one complete turn of wire, measured in adirection along longitudinal axis 16.

In some examples, a pitch of structural support member 20 varies along alength of structural support member 20, such that a stiffness (orflexibility) varies along the length. The pitch may continuously varyalong the length of member 20, or may progressively change, e.g.,include different sections, each section having a respective pitch. Anexample structural support member 20 that has different sections havingdifferent, respective pitches is shown in FIG. 5, which is a sideelevation view of a part of structural support member 20.

As shown in FIG. 5, a pitch of structural support member 20 decreases ina distal direction, such that proximal portion 30 of member 20 has agreater pitch than medial portion 32, which has a greater pitch thanfirst subportion 34A of distal portion 34, which has a greater pitchthan second subportion 34B of distal portion. One or more of theportions 30, 32, 34 of member 20 may have a gradually increasing pitch.Proximal portion 30 may, for example, be positioned within proximalportion 17A (FIG. 1) of catheter body 12, medial portion 32 may bepositioned within medial portion 17C of catheter body 12, and distalportion 34 may be positioned within distal portion 17B of catheter body12.

In one example, proximal portion 30 of member 20 has a pitch of about0.00225 inches (about 0.057 mm), medial portion 32 has a pitch of about0.00250 inches (about 0.064 mm), and distal portion 34 includes firstsubportion 34A having a pitch of about 0.0030 inches (about 0.076 mm)and second subportion 34B having a pitch of that gradually increasesfrom 0.0030 inches to about 0.0070 inches (about 0.18 mm). In someexamples, second subportion 34B may have a pitch that increases at aconstant rate of change along a length of second subportion 34B. Inother examples, second subportion 34B may have a pitch that increases ata varying rate of change along the length.

FIG. 5 is not drawn to scale. In some examples, proximal portion 30 hasa length of about 98 cm, medial portion 32 has a length of about 26 cm,and first subportion 34A of distal portion 34 has a length of about 6cm, and second subportion 34B has a length of about 10 cm. The length ofportions 30, 32, 34 may differ in other examples, and may depend on thedesired flexibility of catheter body 12.

In some examples, in addition to changing stiffness along the length ofstructural support member 20, member 20 can change in diameter along alength of member 20. For example, structural support member 20 may taperfrom a first coil diameter to a second coil diameter. In the exampleshown in FIG. 5, proximal portion 30 of structural support member 20 hasa first coil outer diameter and a first coil inner diameter, distalportion 34 of structural support member 20 has a second coil outerdiameter and a second coil inner diameter, and a medial portion 32 ofstructural support member 20 tapers in outer diameter from the firstcoil outer diameter to the second coil outer diameter, and tapers ininner diameter from the first coil inner diameter to the second coilinner diameter. Medial portion 32 can, for example, have a length thatis substantially the same as medial portion 17C (FIG. 1) of catheterbody 12, which tapers from a first outer diameter to a second outerdiameter in some examples. For example, medial portion 34 can have alength of about 2 inches. The length of medial portion 32 can beselected to accommodate the desired change in pitch or diameter ofmember 20 along medial portion 32.

In examples in which inner liner 18 also tapers from a first outer(and/or inner) diameter to a second outer (and/or inner) diameter(smaller than the first outer (and/or inner) diameter), examples inwhich catheter body 12 tapers from a first outer diameter to a secondouter diameter, or both, structural support member 20 may taper tofollow the change in the outer diameter of inner liner 18, catheter body12, or both inner liner 18 and catheter body 12.

In some examples, structural support member 20 is formed from a singlewire that defines a coil member that changes in outer diameter and innerdiameter, and changes in pitch along the length of member 20. The singlewire may be seamless (or joint-less) in that there are no joints (e.g.,butt joints) between separate portions of wire that are connectedtogether to define a longer wire. Rather, the wire has a unitary bodyconstruction. The contemporaneous change in pitch and inner and outerdiameters of the structural support member 20 including a single,seamless wire may be made possible, at least in part, by the shapememory material from which the wire is formed.

Defining member 20 from a single, seamless wire may increase thestructural integrity of catheter body 12 compared to examples in whichmember 20 is formed from multiple wires that are joined together. Forexample, the joints between wires may adversely affect the tensilestrength or lateral flexibility of member 20, which may adversely affectthe flexibility and pushability of catheter body 12.

Outer jacket 24 is positioned radially outward of inner liner 18 andstructural support member 20, and, in some examples, defines an outersurface of catheter body 12. Although a coating or another material maybe applied over the outer surface of outer jacket 24, outer jacket 24may still substantially define shape and size of the outer surface ofcatheter body 12. Outer jacket 24, together with structural supportmember 20 and inner liner 18, may be configured to define catheter body12 having the desired flexibility, kink resistance, and pushabilitycharacteristics.

Outer jacket 24 may have stiffness characteristics that contribute tothe desired stiffness profile of catheter body 12. For example, outerjacket 24 may be formed to have a stiffness that decreases from aproximal portion of catheter body 12 to a distal portion. For example,outer jacket 24 may be formed from two or more different materials thatenable outer jacket 24 to exhibit the desired stiffness characteristics.

FIG. 6 is a conceptual side elevation view of an example outer jacket 24that includes a plurality of segments 40A-40I (collectively referred toherein as “segments 40” or generally referred to individually as“segment 40”), at least two of the segments 40 having differentdurometers. The segments 40 can each be, for example, sleeves (e.g.,tubular sleeves) that are configured to be positioned over inner liner18 and structural support member 20, and, if present, support layer 22.At least two segments 40 may also define different inner diameters thaneach other, where the inner diameter of a particular sleeve 40 may beselected to accommodate the portion of catheter body 12 in which thesleeve 40 is to be positioned. In some examples, each segment 40 has thesame wall thickness (measured in a direction orthogonal to longitudinalaxis 16 (FIG. 1). In other examples, the wall thicknesses of segments 40may differ.

Segments 40 are situated longitudinally adjacent to each other, e.g., inan abutting relationship, and can be mechanically connected together todefine outer jacket 24 using any suitable technique, such as by welding,an adhesive, or any combination thereof.

The stiffness of outer jacket 24 contributes to the flexibility andstructural integrity of catheter body 12. Accordingly, the durometers ofeach of the segments 40 may be selected to help provide catheter body 12with the desired flexibility characteristics. For example, in someexamples in which catheter body 12 increases in flexibility fromproximal end 12A towards distal end 12B, the durometer of each of theouter jacket segments 40 may decrease in a direction from proximal end24A of outer jacket 24 towards distal end 24B.

In some examples, the durometer of each of the outer jacket segments 40may decrease in a direction from proximal end 24A of outer jacket 24towards distal end 24B and then increase proximate to distal end 24B ofouter jacket 24. In these examples, outer jacket 24 may define a firstsection that decreases in durometer along a length of the first sectionin a direction towards the distal end of the elongated body, and asecond section that is more distal than the first section, includesdistal end 12B of catheter body 12, and has a higher durometer than adistal-most portion of the first section. As a result of such relativestiffness characteristics, distal opening 13 of catheter body 12 mayresist geometric deformation when catheter body 12 is engaged with aguidewire to a greater degree than would occur if the second sectionwere formed of the material of the distal-most portion of the firstsection.

For example, a durometer of a distal-most outer jacket section 40I maybe greater than a durometer than adjacent section 40H. In this example,segments 40A-40H may define the first section of outer jacket 24, andsegment 40I may define the second section. As another example, thedurometers of outer jacket segments 40H and 40I may be greater than adurometer of outer jacket segment 40G, such that segments 40A-40G definethe first section and outer jacket segments 40H and 40I define thesecond section. In some examples, distal-most segment 40I of outerjacket 24 has a higher durometer, such that it is stiffer, than asegment in the middle of catheter body 12, e.g., one or more of segments40C-40G.

While it may be desirable in some cases to provide a catheter body 12having a relatively flexible distal portion, increasing the hardness ofa distal-most section of outer jacket 24 relative to a more proximalsection that is directly adjacent to the distal-most section, mayprovide certain advantages in some examples. For example, increasing thehardness of the distal-most section may configure distal opening 13 ofcatheter body 12 to resist geometric deformation when distal opening 13(FIG. 1) of catheter body 12 is engaged with a guidewire, which may helpsupport the navigation of catheter body 12 through vasculature. Thedistal-most section of outer jacket 24 that exhibits the increasedstiffness may be a relatively small length of catheter body 12 and,therefore, may not affect the overall flexibility of catheter body 12.

When catheter body 12 is advanced through vasculature of a patient,catheter body 12 may be inserted over a previously placed guidewire,which defines a pathway for catheter body 12 through the vasculature ofthe patient. Due to the difference in cross-sectional size of catheterbody 12 and the guidewire, the guidewire may not substantially fully(e.g., completely or nearly completely) occupy the space within innerlumen 26. As a result, when the guidewire is not centered within innerlumen 26, only one side of catheter body 12 may engage with theguidewire, e.g., as catheter body 12 is guided over the guidewire alonga curvature. The guidewire may cause a radially outward force to beapplied to the wall of catheter body 12. The hardness of the distal-mostportion of outer jacket 24 is selected to help the distal tip ofcatheter body 12 resist ovalization or other geometric deformation insuch circumstances, e.g., when the wall of the catheter body 12 isengaged with a guidewire. Ovalization or other geometric deformation ofcatheter body 12 may cause the shape of distal opening 13 of catheterbody 12 to change shape, which may be undesirable in some situations, asit may adversely affect the navigability of the catheter body throughthe vasculature.

As discussed in further detail below with respect to FIG. 7, in someexamples, structural support member 20 does not extend all the way todistal end 12B of catheter body 12, but, rather, ends at a point that isproximal to the distal end 12B. For example, structural support member20 may end about 0.25 mm to about 1 mm, such as about 0.5 mm, fromdistal end 12B. Thus, structural support member 20 may not contribute tothe structural integrity of a distal-most portion of catheter body 12.Extending structural support member 20 to the distal end 12B of catheterbody 12 may limit the flexibility of the distal-most portion. Byconfiguring outer jacket 24 to include a second section that has ahigher durometer than a distal-most portion of the first section, thedistal tip of catheter body 12 may exhibit a stiffness that issufficient to facilitate a distal opening 13 that is resists geometricdeformation, but is also flexible enough to guide catheter 12 throughtortuous vasculature. In this way, increasing the stiffness of outerjacket 24 at a distal tip of catheter body 12 may help maintain desirednavigability of catheter body 12, even without the presence ofstructural support member 20 in the distal tip.

In some cases, catheter body 12 is advanced over an inner catheterhaving a smaller outer diameter than catheter body 12, rather thandirectly over a guidewire. The inner catheter may, for example, helpfill the space between the guidewire and the outer surface of outercatheter body 12 in order to help minimize the ledge effect, which mayoccur when a distal tip of catheter body 12, particularly the portion ofthe edge of the tip that tracks the outside of a curve formed by thebody 12, engages with or abrades a wall of vasculature as catheter body12 is advanced over a guidewire through a curve in the vasculature. Theledge effect may, at least in part, be attributable to unopposed spacebetween the guidewire and inner lumen 26 of catheter body 12. In someexamples, configuring a distal tip of catheter body 12 to define opening13 configured to resist geometric deformation may allow catheter body 12to be guided through vasculature over a guidewire, without need for aninner catheter. This may not only reduce costs associated with themedical procedure, but may also reduce the time required to reach thetarget tissue site as a step of guiding the inner catheter to the tissuesite before guiding catheter 10 to the target tissue site may beeliminated.

In examples in which catheter 10 is used for aspiration, in addition to,or instead of, being selected to configure the distal tip of catheterbody 12 to resist geometric deformation when catheter body 12 isadvanced over a guidewire, the hardness of the second section of outerjacket 24 may be selected to help distal opening 13 of catheter body 12resist geometric deformation during aspiration. For example, at leastouter jacket segment 40I, which together with inner liner 18, definesdistal opening 13, may have a stiffness that allows opening 13 tosubstantially hold its shape and not collapse inward towards or intoinner lumen 26 when the vacuum force is applied to inner lumen 26.

Outer jacket segments 40 may each be formed from the same material or atleast two segments 40 may be formed from different materials. Examplematerials for segments 40 include, but are not limited to, polymers,such as a polyether block amide (e.g., PEBAX®, commercially availablefrom Arkema Group of Colombes, France), an aliphatic polyamide (e.g.,Grilamid®, commercially available from EMS-Chemie of Sumter, S.C.),another thermoplastic elastomer or other thermoplastic material, orcombinations thereof. In one example, segment 40A is formed from analiphatic polyamide and segments 40B-40I are formed from a polyetherblock amide. The compositions of the polyether block amide may bemodified to achieve segments 40 having different durometers.

In some examples, segment 40A has a durometer greater than or equal toabout 72D, segment 40B has a durometer greater than or equal to about72D and less than or equal to the durometer of segment 40A, segment 40Chas a durometer of about 72D, segment 40D has a durometer of about 63D,segment 40E has a durometer of about 55D, segment 40F has a durometer ofabout 40D, segment 40G has a durometer of about 35D, segment 40H has adurometer of about 25D, and segment 40I has a durometer greater thanabout 25D, such as a about 55D. In other examples, however, one or moreof the segments 40 may have other hardness values. The hardness of thesegments 40 may be selected to obtain more or less flexibility,torqueability, and pushability for all or part of catheter body 12.

Segments 40 may each have any suitable length, which may be selectedbased on the desired flexibility profile of catheter body 12. In someexamples, proximal, distal, and medial portions 17A-17C (FIG. 1) ofcatheter body 12 may have their own respective outer jacket segments 40that each begin and end at the proximal and distal ends of thecorresponding catheter body portion 17A-17C. In other examples, one ofthe outer jacket segments 40 may extend at least over both proximalportion 17A and tapering medial portion 17C, and/or over both medialportion 17C and distal portion 17B.

FIG. 7 is a conceptual cross-sectional view of an example distal-mostportion of catheter body 12, which includes the distal tip of catheterbody 12. Distal opening 13 is located at the distal tip. In someexamples, the distal tip is defined by the portion of catheter body 12including distal-most segment 40I of outer jacket 24. In other examples,the distal tip may include additional sections of outer jacket 24.

As shown in FIG. 7, inner liner 18 and outer jacket 24 extend to distalend 12B of catheter body 12, whereas structural support member 20 andsupport layer 22 both terminate at a location that is proximal to distalend 12B. In the example shown in FIG. 7, structural support member 20and support layer 22 are at least partially coextensive (e.g., extendover a common space) with at least a medial portion of inner liner 18and outer jacket 24 (e.g., segments 40B-40H, or only a portion ofsegments 40B-40H), but not with the portions of inner liner 18 and outerjacket 24 at the distal tip of catheter body 12. Thus, in the exampleshown in FIG. 7, distal opening 13 of catheter body 12 is defined byinner liner 18 and outer jacket 24, but not by structural support member20 and support layer 22. In these examples, the distal tip of catheterbody 12 may consist essentially of inner liner 18 and outer jacket 24.While the distal tip may also include adhesive or the like between innerliner 18 and outer jacket 24, a coating on outer jacket 24, or otherlayers, the structural characteristics of the distal tip of catheterbody 12 may be primarily influenced by only inner liner 18 and outerjacket 24.

A distal tip that consists essentially of only inner liner 18 and outerjacket segment 24 may define a relatively thin-walled distal tip, whichmay allow for a greater inner diameter to outer diameter ratio at thedistal tip. A larger inner diameter to outer diameter ratio may beuseful for aspiration, target (e.g., thrombus) capture, as well asmaneuvering devices within inner lumen 26, such that the increasing theinner diameter to outer diameter ratio may be desirable.

In the example shown in FIG. 7, structural support member 20 and supportlayer 22 both terminate in a region of outer jacket 24 that has a lowerdurometer than distal-most segment 40I of outer jacket 24. In otherexamples, however, one or both of structural support element 22 andsupport layer 22 may terminate in a portion of catheter body 12 thatincludes outer jacket segment 40I, such that one or both of structuralsupport member 20 and support layer 22 overlap with distal-most outerjacket segment 40I.

When distal end 12B of catheter body 12 is introduced into vasculatureof a patient, distal end 12B of catheter body 12 leads catheter 10through the vasculature. As a result, it may be desirable for distal end12B of catheter body 12 to define an atraumatic tip, such that ascatheter body 12 is navigated through curves in the vasculature, distalend 12B provides a relatively smooth and atraumatic interface with thewalls of vasculature (“vascular walls”). In the example shown in FIG. 7,the distal tip of catheter body 12 is configured to be relativelyatraumatic when it engages with tissue (e.g., vascular walls) of thepatient, yet stiff enough to allow at least distal opening 13 tosubstantially maintain its cross-sectional shape or otherwise resistgeometric deformation as the distal tip is maneuvered over a guidewireor another device (e.g., another catheter). For example, outer jacketsegment 40I may define an outer surface 42 that tapers from a largerouter diameter to a smaller outer diameter at distal end 12A of catheterbody 12. The angled outer surface 42 (angled relative to thelongitudinal outer surface 43 of catheter body 12) may help guide thedistal tip of catheter body 12 along a curved vascular wall, and mayhelp reduce adverse interactions between the distal tip of catheter body12 and the vascular wall.

Because the distal tip of the example of catheter body 12 shown in FIG.7 is devoid of structural support member 20 and support layer 22, athickness of outer jacket 24 may be increased in some examples toaccommodate angled outer surface 42 without requiring a correspondingincrease the outer diameter of catheter body 12. For example, outerjacket segment 40I may be thicker than outer jacket segment 40H (thethickness being measured in a direction orthogonal to longitudinal axis16), but the outer surfaces of outer jacket segments 40H, 40I may besubstantially continuous.

Distal-most segment 40I of outer jacket 24 at distal end 12B of catheterbody 12 can be formed of any suitable material. For example, segment 40Imay be formed of a polyether block amide (e.g., PEBAX), which isrelatively stiff and may allow the distal tip of catheter body 12, and,therefore, distal opening 13, to substantially maintain its shape andresist geometric deformation as it is guided through vasculature over aguidewire or another device.

In some examples, catheter body 12 includes radiopaque marker 44, whichmay be attached to inner liner 18, support layer 22, and/or outer jacket24 using any suitable technique. In some examples, outer jacket 24 ispositioned over marker 44, which may help prevent an outer surface ofmarker 44 from being exposed. In the example shown in FIG. 7, radiopaquemarker 44 is at least partially embedded in support layer 22 (e.g.,fully embedded or partially embedded along its longitudinal length) andadhered to inner liner 18 via support layer 22. In other examples,radiopaque marker 44 may be attached to inner liner 18 via outer jacket24, which, when heat shrunk over member 20 and inner liner 18, orotherwise secured to member 20 and inner liner 18, may substantially fixmarker 44 in place. Radiopaque marker 44 may be formed from any suitablematerial, and may be in the form of a continuous ring, a discontinuousring, or multiple segments that extend around the perimeter of catheterbody 12. Radiopaque marker 44 may be positioned to indicate the locationof the distal tip of catheter body 12 and, therefore, may be positionedproximate to distal opening 13.

In the example shown in FIG. 7, the portion of catheter body 12 that isdistal to radiopaque marker 44 may consist essentially of inner liner 18and outer jacket 18, which may be advantageous for at least the reasonsdiscussed above. In other examples, the portion of catheter body 12 thatis distal to radiopaque marker 44 may also include other structures,such as, but not limited to, structural support member 20 and supportlayer 22.

Although FIG. 7 illustrates catheter body 12 including structuralsupport member 20 that includes a coil, in other examples, the featuresdescribed with respect to FIG. 7 and the other features described hereinmay be used with other types of structural support members 20. Forexample, rather than structural support member 20 in the form of a coil,in other examples of catheter body 12 having a distal tip defined byouter jacket segment 40I and inner liner 18, and devoid of structuralsupport member 20, member 20 may include a braided structure that isattached to inner liner 18, a cut or uncut hypotube that overlies innerliner 18, or any combination thereof.

In addition, although FIG. 7 is described with respect to catheter body12, in other examples, one or more features of the distal tipconfiguration shown in FIG. 7 may be used with catheter bodies havingother configurations such as catheter bodies having substantiallyconstant outer diameters, catheter bodies that include an inner linerformed from multiple inner liner sections connected together, catheterbodies that include a structural support member that includes one ormore sections mechanically connected together or a structural supportmember that does not have a varying pitch and/or a varying diameter,catheter bodies that include one or more layers of material between anouter surface of structural support member 20 and outer jacket 24, orany combination thereof.

The catheters described herein can be formed using any suitabletechnique. FIGS. 8 and 9 are flow diagrams of example methods of formingcatheter 10, and are described with reference to FIGS. 10 and 11, whichare schematic side elevation views of assemblies after some steps of themethods. In accordance with the technique shown in FIG. 8, inner liner18 may be positioned over mandrel 48 (50). In some examples, inner liner18 is a unitary, seamless body, and may be positioned over mandrel 48 byat least inserting mandrel 48 through an end of inner liner 18.

As discussed above, in some examples, catheter body 12 tapers fromproximal portion 17A (FIG. 1) having a first, constant outer diameter todistal portion 17B having a second, constant outer diameter, e.g., alongmedial portion 17C, which continuously tapers from the first outerdiameter to the second outer diameter. Mandrel 48 defines acorresponding change in outer diameter. For example, as shown in FIG.10, mandrel 48 includes proximal portion 49A having a first mandrelouter diameter that is substantially constant (e.g., constant or nearlyconstant, except for minor manufacturing variances) along proximalportion 49A, distal portion 49B having a second mandrel outer diameterthat is substantially constant along distal portion 49B, and medialportion 49C, which continuously tapers from the first mandrel outerdiameter to the second mandrel outer diameter.

The length (measured in a direction parallel to a longitudinal axis ofmandrel 48) of each of portion 49A-49C may be selected based on thedesired length of proximal, distal, and medial portions 17A-17C,respectively, of catheter body 12. For example, medial portion 49C mayhave a length of about length of about 1 inch (about 2.5 cm) to about 3inches (about 7.6 cm), such as about 2 inches (about 5 cm).

Mandrel 48 may be formed from any suitable material. The material fromwhich mandrel 48 is formed may be configured to relatively easilyrelease inner liner 18, e.g., after catheter body 12 is formed overmandrel 48. For example, mandrel 48 may be formed from an extruded PTFE(e.g., mandrel 48 may consist of or consist essentially of an extrudedPTFE). An extruded PTFE material may define a relatively lubriciousouter surface, which may allow for relatively easy release of innerliner 18 from mandrel 48, e.g., even in the absence of one or moreadditional lubricious coatings on the outer surface of mandrel 48. Inaddition, an extruded PTFE material may be ground or otherwise shaped todefine mandrel 48 having the desired portion 49A-49C. Medial portion49C, which continuously tapers in outer diameter may be relativelydifficult to define with some materials. However, an extruded PTFE bead,which may be a solid, unitary rod, may be relatively easily manipulated(e.g., by grinding) to achieve the desired geometry to provide medialportion 49C.

In some examples, in the technique shown in FIG. 8, after positioninginner liner 18 over mandrel 48, inner liner 18 may be heat shrunk ontomandrel 48 and may, as a result, conform to the outer surface of mandrel48 and acquire the tapered profile of mandrel 48. For example, innerliner 18 may have a somewhat larger inner diameter than mandrel 48 inorder to permit inner liner 18 to be relatively easily slipped over oneend of mandrel 48. In other examples, however, heat shrinking may not benecessary. For example, in addition to, or instead of, heat shrinking,inner liner 18 may be longitudinally stretched over mandrel 48 in orderto substantially conform to the outer surface of mandrel 48. In eitherexample, inner liner 18 may define a constant inner diameter or may havedifferent inner diameters, e.g., corresponding to the outer diametersdefined by mandrel 48.

Using a single PTFE bead that is ground or otherwise shaped to definemandrel 48 may help reduce surface protrusions or other irregularitiesthat may transfer from outer surface of mandrel 48 to the inner surfaceof inner liner 18. Surface protrusions or other irregularities along theinner surface of inner liner 18 may interfere with the passage ofdevices within inner lumen 26 of catheter body 12. Thus, a smootherinner surface of inner liner 18 may be desirable in some cases, e.g., inorder to allow a clinician to guide catheter body 12 over a guidewirewith relative ease, or to introduce another medical device through innerlumen 26.

In other examples, multiple extruded PTFE portions may be attachedend-to-end to define mandrel 48. For example, PTFE portionscorresponding to portions 49A-49C may be adhered or welded to definebutt joints that are axially separated along a length of mandrel 48.However, attaching multiple PTFE portions to define mandrel 48 mayintroduce more surface protrusions or other irregularities along theinner diameter of inner liner 18 compared to examples in which a singlePTFE bead is used to form mandrel 48. For example, the joints betweenthe PTFE portions may cause surface protrusions to form along the innersurface of inner liner 18 when inner liner 18 is positioned over mandrel48 and substantially conforms to the outer surface of mandrel 48.

Because mandrel 48 defines an outer diameter that changes over a lengthof mandrel 48, when inner liner 18 is positioned over mandrel 48 andsubstantially conforms to an outer surface of mandrel 18, inner liner 18may be acquire the profile of mandrel 48. Thus, mandrel 48 helps todefine inner liner 18 that includes a proximal inner lumen portionhaving a first inner lumen diameter, a distal inner lumen portion havinga second inner lumen diameter, and a medial inner lumen portion thatgradually tapers in diameter from the first inner lumen diameter to thesecond inner lumen diameter.

After positioning inner liner 18 over mandrel 48 (50), structuralsupport member 20 may be positioned over inner liner 18, as shown inFIG. 11 (52). In examples in which structural support member 20 includesa coil member, the wire defining the coil member may be wound over anouter surface of inner liner 18 or pushed over inner liner 18. The coilmember can be, for example, a single coil member that is devoid of anyjoints. In some examples, the structural configuration of structuralsupport member 20 may be at least partially defined prior to beingpositioned over inner liner 18. For example, a shape memory wire (e.g.,a nickel-titanium wire) or a wire of an otherwise heat-settable metal oralloy may be wound over a different mandrel (e.g., a “coil mandrel”) onwhich inner liner 18 is not present or over mandrel 48 (e.g., beforeinner liner 18 is positioned on mandrel 48) to define at least one ofthe desired coil pitch, the desired coil diameter, the desired taperingprofile (e.g., a continuous tapering or progressive tapering), or thedesired length of structural support member 20, and then heat set tosubstantially hold its shape. The wire may then be subsequently unwoundfrom the mandrel onto a reel or a bobbin, and then positioned over innerliner 18. Structural support member 20 may be positioned over innerliner 18 by, for example, winding member 20 over inner liner 18 (e.g.,winding member 20 from the bobbin or reel onto inner liner 18) or bypushing inner member 20 over an end of inner liner 18.

In some examples, a wire formed from a shape memory metal/alloy or anotherwise heat-settable metal/alloy may be preformed into a helical coilhaving a constant pitch and the desired diameters, including the desiredtaper, and then, once positioned over inner liner 18, the layout of thecoiled wire may be adjusted to achieve the desired pitch profile (e.g.,the change in pitch over the length) of structural support member 20.For example, the pitch of the wire may be adjusted over inner liner 18to achieve the desired pitch profile (e.g., as described with referenceto FIG. 5). These adjustments may be made manually, by hand, or by acomputer-controlled device. In other examples, however, a wire may bepreformed into a helical coil having the desired pitch profile anddiameters for structural support member 20 before being positioned overinner liner 18.

Defining some or all of the structural characteristics of structuralsupport member 20 prior to positioning member 20 over inner liner 18 mayhelp control the structural characteristics of structural support member20, as well as control the uniformity of the structural support member20 of multiple catheter bodies. Pre-shaping and shape-setting the member20 as a coil (as opposed to ordinary wire stock) causes the member 20 toconform closely to the inner liner 18 as the member 20 is wound onto theliner 18. This close conformance, on its own and in combination with theresulting reduced need for adhesives or other measures to keep the woundmember in place on the liner 18, helps reduce the wall thickness T inthe catheter body 12. In addition, shape-setting the structural supportmember 20 on a separate, heat-resistant mandrel enables the constructionof the catheter body 12 using the member 20 on a mandrel made of PTFE orother lubricious, non-heat resistant material.

In some examples, the structural configuration of structural supportmember 20 may be at least partially defined as it is wound over innerliner 18 in some examples. For examples, a shape memory wire or astainless steel wire may be wound over inner liner 18 to define thedesired coil pitch, the desired diameter(s), the desired taper, thedesired length, or any combination thereof of member 20. The shapememory wire may then be heat set to define structural support member 20.

Structural support member 20 may be secured in place relative to innerliner 18 using any suitable technique. For example, member 20 may beadhered to inner liner 18. In some examples, an adhesive and/or apolymer is applied over member 20 after member 20 is positioned overinner liner 18. In other examples, as described with reference to FIG.9, an adhesive may be positioned over inner liner 18 prior topositioning structural support member 20 over inner liner 18. Inaddition to, or instead of, an adhesive, outer jacket 24 may be used tosecure structural support member 20 to inner liner 18.

In the technique shown in FIG. 8, after structural support member 20 ispositioned over inner liner (52), outer jacket 24 is positioned over anouter surface of structural support member (54). In some examples, outerjacket 24 is adhered to an outer surface of structural support member20, e.g., an adhesive and/or a polymer may be applied to outer surfaceof member 20 prior to positioning outer jacket 24 over member 20 andthen cured after outer jacket 24 is positioned over member 20. Inaddition to, or instead of, the adhesive, outer jacket 24 may be heatshrunk over member 20 and inner liner 18. In some examples, the heatshrinking of outer jacket 24 helps secure member 20 in place relative toinner liner 18.

As noted above, in some examples, catheter body 12 includes supportlayer 22. In the method shown in FIG. 9, in order to form support layer22, a layer of thermoset polymer is applied to an outer surface of innerliner 18 after inner liner 18 is positioned over mandrel 48 but beforestructural support member 20 is positioned over inner liner 18 (58). Thethermoset polymer may be, for example, a viscoelastic thermosetpolyurethane (e.g., Flexobond 430).

Structural support member 20 may then be positioned over inner liner 18and the thermoset polymer (52). At least some of the thermoset polymermay be displaced by member 20 when member 20 is positioned over innerliner 18, which may cause at least some of the thermoset polymer to bepositioned between the turns of the wire defining member 20. Positioningthe thermoset polymer over inner liner 18 prior to positioning member 20over inner liner 18 in this manner may help minimize or event eliminateair pockets that may form in support layer 22. For example, the forceapplied by member 20 (in a direction towards inner liner 18) that causesthe thermoset polymer to be displaced may also help positively displaceany air that may be positioned between member 20 and the thermosetpolymer. In contrast, depositing a polymer over member 20 and innerliner 18 may create air pockets between member 20 and the polymer. Airpockets may contribute to the tendency of catheter body 12 to kink.

In addition, by applying the layer of thermoset polymer material overthe outer surface of inner liner 18 before positioning structuralsupport member 20 over inner liner 18, the thermoset polymer may bepositioned between inner liner 18 and member 20. In contrast, if thethermoset polymer is applied over member 20 after member 20 ispositioned over inner liner 18, the thermoset polymer may not bepositioned between inner liner 18 and member 20, which may reduce thestructural integrity of catheter body 12.

In some examples, in order to help minimize the wall thickness ofcatheter body 12, substantially no part of support layer 22 (e.g., nosupport layer material or nearly no support layer material) may bepositioned between member 20 and outer jacket 24. Thus, to minimize oreven eliminate adhesive from extending radially outwards of structuralsupport member 20, the thermoset polymer may be applied in a relativelythin layer, e.g., in a layer having a thickness less than a thickness ofmember 20 measured in a direction radially outward from inner liner 18.

As discussed above, structural support member 20 may be at leastpartially preformed into a helical coil before being positioned overinner liner 18 and the thermoset polymer. The thermoset polymer may beconfigured to be time cured and/or heat cured, such that the adhesivemay not substantially immediately fix the position of member 20 relativeto inner liner 18. As a result, in some examples, the pitch of the coil(e.g., along the medial portion 32 (FIG. 5)) may be adjusted aftermember 20 is positioned over inner liner 18 and the thermoset polymer.

In accordance with the technique shown in FIG. 9, after structuralsupport member 20 is positioned over inner liner 18 and the thermosetpolymer (52), the thermoset polymer is cured (60), e.g., by heatingand/or time-curing. The cured thermoset polymer defines support layer22. In some examples, such as some examples in which the thermosetpolymer is a thermoset polyurethane, the subassembly including mandrel48, inner liner 18, the thermoset polymer, and structural support member20 may be heat cured, e.g., at a temperature of about 200 degreesFahrenheit (° F.) (about 93.33 degrees Celsius (° C.)) for about twohours.

After the thermoset polymer is cured, outer jacket 24 may be positionedover the outer surface of structural support member 20 and over portionsof support layer 22 that are n not covered by structural support member20 (54). For example, if outer jacket 24 comprises a plurality ofdifferent segments 40 (FIG. 6), at least some of the segments 40 may beslid over the outer surface of member 20. The segments 40 may bemechanically connected together and configured to substantially conformto the outer surface of support layer 22 and member 20 using anysuitable technique. In some examples, segments 40 are formed from a heatshrinkable material. A heat shrink tube may be positioned over segments40, and heat may be applied to cause the heat shrink tube to wraptightly around segments 40. The heat and wrapping force may causesegments 40 to fuse together to define a substantially continuous outerjacket 24. The heat shrunk tube may then be removed from the assembly,e.g., via skiving or any suitable technique.

The use of heat shrinking to apply outer jacket 24 to the subassemblyincluding inner liner 18, support layer 22, and structural supportmember 20 may help eliminate the need for an adhesive between structuralsupport member 20 and outer jacket 24. This may help minimize the wallthickness of catheter body 12 and, therefore, increase the innerdiameter of catheter body 12 for a given outer diameter. In addition,the absence of an adhesive layer adhering support layer 22 andstructural support member 20 to outer jacket 24 may contribute to anincreased flexibility of catheter body 22.

In some examples, all of the outer jacket segments 40 are attached tothe subassembly including inner liner 18, support layer 22, andstructural support member 20 in this manner. In other examples, all ofthe outer jacket segments 40 except for the one or more segments 40 atthe distal tip of catheter body 12 are attached to the subassemblyincluding inner liner 18, support layer 22, and structural supportmember 20 in this manner. In this example, after the heat shrink tubingis removed, the one or more segments 40 (e.g., segment 40I) selected tobe at the distal tip of catheter body 12 may be positioned over thedistal end of inner liner 18 and welded or otherwise mechanicallyconnected to the distal-most outer jacket segment 40 (e.g., segment 40H)that is already attached to the subassembly. In this way, distal tip atdistal end 12B of catheter body 12 may be formed to include inner liner18 and outer jacket 24, but may be substantially devoid (devoid ornearly devoid) of support layer 22 and structural support member 20.

In addition, in examples in which catheter body 12 includes radiopaquemarker 44, marker 44 may be positioned over inner liner 18, as shown inFIG. 11, before positioning outer jacket segments 40 over member 20, orat least before positioning the distal outer jacket segments 40 overmember 20. In addition, hub 14 can be attached to proximal end 14A ofcatheter body 12 using any suitable technique, such as an adhesive,welding, or any combination thereof.

A thermoset polymer may be configured to substantially retain its curedstate (and not reflow), even in the presence of the heat that is appliedduring the heat shrinking of outer jacket segments 40 onto support layer22 and structural support member 20. For example, the meltingtemperature of the thermoset polymer defining support layer 22 may begreater than the temperature to which support layer 22 is subjectedduring the heat shrinking of outer jacket segments 40 onto support layer22 and structural support member 20. Thus, support layer 22 including athermoset polymer may substantially fix the position of structuralsupport member 20 relative to inner liner 18 during the placement ofouter jacket 24 over support layer 22 and member 20. A support layer 22that is configured to prevent structural support member 20 from shiftingrelative to inner liner 18 during the placement of outer jacket 24 oversupport layer 22 and member 20 in this manner may help control thestructural integrity of catheter body 12.

In addition, a thermoset polymer that is configured to substantiallyretain its cured state during the placement of outer jacket 24 may helpminimize or even prevent the material forming support layer 22 fromreflowing into the space between outer jacket 24 and structural supportmember 20. As discussed above, minimizing or event eliminating thepresence of support layer 22 material between member 20 and outer jacket24 may help minimize the wall thickness of catheter body 12 and,therefore, increase the inner diameter of catheter body 12 for a givenouter diameter.

In some examples, catheter 10 or catheter body 12 may be a part of anassembly that includes, e.g., a guidewire and/or another catheter. Thecatheter 10 or catheter body 12 in such an assembly can be any of theembodiments or examples of the catheter 10 or catheter body 12 disclosedherein. The guidewire may be used to guide catheter 10 to a targettissue site within the vasculature of a patient. In addition, in someexamples, the additional catheter of the assembly may also be configuredto guide catheter 10 or body 12 to a target tissue site within thevasculature of a patient. The additional catheter of the assembly may besubstantially similar (e.g. identical or nearly identical) inconstruction to catheter 10 (including any of the embodiments orexamples of the catheter 10 disclosed herein), but may haveproportionally greater or smaller dimensions, such that the catheterbodies of the catheters may nest together. For example, the additionalcatheter of the assembly may have a smaller outer diameter than catheterbody 12 and may be placed and/or guided over the guidewire, and thencatheter 10 or catheter body 12 may be guided over the additionalcatheter. If, for example, catheter 10 or body 12 tapers from a 6 Frenchouter diameter to a 5 French outer diameter, then the additionalcatheter may taper from a 4 French outer diameter to a 3 French outerdiameter. The assembly may therefore comprise the catheter 10 with theadditional catheter positioned in the inner lumen 26 of the catheter,and may further comprise the guidewire positioned in the inner lumen ofthe additional catheter.

Each of the components of the assembly may be slidably disposed relativeto the other(s) so that each may be advanced and/or retracted over orwithin the other(s). For example, when the additional catheter ispositioned in the lumen of the catheter 10, the catheter 10 may beadvanced or retracted longitudinally over the additional catheter,and/or the additional catheter can be advanced or retractedlongitudinally within the catheter 10. The use of the additionalcatheter in this manner may help reduce any adverse interactions withtissue attributable to the ledge effect. For example, if in use of anassembly having a guidewire the guidewire is first advanced into thevasculature, the additional catheter may next be advanced over theguidewire before the catheter 10 is advanced over the additionalcatheter. The difference in outer diameter between the guidewire and theadditional catheter (and between the additional catheter and thecatheter 10) is less than the difference in outer diameter between theguidewire and the catheter 10. Therefore, any ledge effect arising fromadvancing the catheter 10 over a “bare” guidewire may be mitigating byuse of the additional catheter in this manner. In other examples, theadditional catheter of the assembly may have a larger outer diameterthan catheter 10 or body 12 and may be guided over catheter 10 or body12 to a target tissue site within the vasculature of the patient. If,for example, catheter 10 or body 12 tapers from a 4 French outerdiameter to a 3 French outer diameter, then the additional catheter maytaper from a 6 French outer diameter to a 4 French outer diameter.

In some examples, a method of using catheter 10 comprises introducing aguidewire or an inner catheter into vasculature (e.g., an intracranialblood vessel) of a patient via an access point (e.g., a femoral artery),and guiding catheter body 12 over the guidewire or the inner catheter.In examples in which outer jacket 24 of catheter body 12 increases instiffness at the distal tip of catheter body 12, e.g., as discussed withrespect to FIGS. 6 and 7, distal opening 13 may resist geometricdeformation, even as it engages with the guidewire. For example, whenintroducing the guidewire into the vasculature, a curve may be formed inthe guidewire. Catheter body 12 may be advanced catheter over the curvein the guidewire and the distal opening of the catheter may resistgeometric deformation when the catheter is advanced over the curve to agreater degree than would occur if the second section were formed of thematerial of the distal portion of the first section.

Once distal end 12B of catheter body 12 is positioned at the targettissue site, which may be proximal to thromboembolic material (e.g., athrombus), the thromboembolic material be removed from the vasculaturevia catheter body 12. For example, the thromboembolic material may beaspirated from the vasculature by at least applying a vacuum force toinner lumen 24 of catheter body 12 via hub 14 (and/or proximal end 12A),which may cause the thromboembolic material to be introduced into innerlumen 24 via distal opening 13. Optionally, the vacuum or aspiration canbe continued to thereby draw the thromboembolic material proximallyalong the inner lumen 24, all or part of the way to the proximal end 12Aor hub 14. As a further option, the aspiration or vacuum may cause thethromboembolic material to attach or adhere to the distal tip; in such acase the catheter 10 or catheter body 12 and the thromboembolic materialcan be withdrawn from the vasculature together as a unit, for examplethrough another catheter that surrounds the catheter 10 or catheter body12. In examples in which outer jacket 24 of catheter body 12 increasesin stiffness at the distal tip of catheter body 12, e.g., as discussedwith respect to FIGS. 6 and 7, distal opening 13 may resist geometricdeformation during the aspiration. As another example, thethromboembolic material may be removed from the vasculature usinganother technique, such as via an endovascular retrieval devicedelivered through the inner lumen 26 of the catheter body 12. In such amethod the catheter body 12 can be inserted into the vasculature (forexample using any technique disclosed herein) and the retrieval deviceadvanced through the inner lumen 26 (or through another catheter, suchas a microcatheter, inserted into the vasculature through the innerlumen 26) so that the device engages the thromboembolic material. Theretrieval device and the material engaged thereby (together with anyother catheter or microcatheter) can then be retracted into the innerlumen 26 and removed from the patient. Optionally, aspiration can beperformed with or through the catheter body 12 during retraction of theretrieval device and thromboembolic material into the catheter body 12.The vasculature can comprise the neurovasculature, peripheralvasculature or cardiovasculature. The thromboembolic material may belocated using any suitable technique, such as fluoroscopy, intravascularultrasound or carotid Doppler imaging techniques.

Various examples have been described. These and other examples arewithin the scope of the following claims.

What is claimed is:
 1. A catheter comprising: an inner liner defining aninner lumen; an outer jacket; a structural support member positionedbetween at least a portion of the inner liner and the outer jacket anddefining a plurality of spaces between portions of the structuralsupport member; and a support layer comprising an adhesive, the supportlayer mechanically connecting the structural support member to the innerliner, wherein the support layer is positioned in the plurality ofspaces, and wherein the structural support member and the inner linerare not adhered to the outer jacket with adhesive.
 2. The catheter ofclaim 1, wherein the structural support member comprises a coil defininga plurality of turns, the plurality of turns comprising a first turn anda second turn, a first surface of the first turn of the coil and asecond surface of the second turn of the coil defining a space of theplurality of spaces, wherein the support layer is positioned in thespace defined by the first surface and the second surface such that thesupport layer extends from the first surface to the second surface. 3.The catheter of claim 1, wherein the structural support member comprisesa braid.
 4. The catheter of claim 1, wherein the support layer extendsbetween the inner liner and the outer jacket within the plurality ofspaces.
 5. The catheter of claim 1, wherein the adhesive is a thermosetadhesive.
 6. The catheter of claim 5, wherein the thermoset adhesivecomprises a urethane adhesive.
 7. The catheter of claim 1, wherein onlyone structural support member is positioned between the outer jacket andthe inner liner.
 8. The catheter of claim 7, wherein the inner liner,the outer jacket, and the structural support member define an elongatedbody, and wherein the structural support member is a single coil thatprogressively changes in pitch as it extends distally through theelongated body, the single coil being devoid of any joints.
 9. Thecatheter of claim 7, wherein the inner liner, the outer jacket, and thestructural support member define an elongated body, and wherein thestructural support member is a single coil that progressively changes inpitch as it extends distally through the elongated body, and wherein afirst pitch of the single coil in a proximal portion of the elongatedbody is about 0.00225 inches (about 0.057 mm), a second pitch of thesingle coil in a medial portion of the elongated body is about 0.00250inches (about 0.064 mm), a third pitch of the single coil in a distalportion of the elongated body is 0.0030 inches (about 0.076 mm), and afourth pitch of the single coil in a distal portion of the elongatedbody is 0.0070 inches (about 0.18 mm).
 10. The catheter of claim 1,wherein the outer jacket comprises a plurality of outer jacket sectionshaving different durometers.
 11. The catheter of claim 1, wherein theouter jacket comprises a heat-shrinkable material, the outer jacketbeing heat shrunk over the support layer and the structural supportmember.
 12. The catheter of claim 1, wherein no material is presentbetween at least a portion of the structural support member and theouter jacket.
 13. The catheter of claim 1, wherein the support layer isnot positioned between the structural support member and the outerjacket.
 14. The catheter of claim 1, wherein the inner liner, the outerjacket, and the structural support member define an elongated body, andwherein the outer jacket comprises: a first section decreasing indurometer along a length of the first section in a direction towards adistal end of the elongated body; and a second section more distal thanthe first section and including the distal end of the elongated body,the second section having a higher durometer than a distal portion ofthe first section, wherein the second section and the inner liner definea distal opening of the elongated body.
 15. The catheter of claim 14,wherein the structural support member extends along the first section ofthe outer jacket and does not extend along the second section.
 16. Thecatheter of claim 14, wherein a distal tip of the elongated bodyincluding the distal end of the elongated body consists essentially ofthe inner liner and the outer jacket.
 17. The catheter of claim 14,further comprising a radiopaque marker coupled to the elongated body,wherein the elongated body distal to the radiopaque marker consistsessentially of the inner liner and the outer jacket.
 18. The catheter ofclaim 14, wherein the inner liner extends distally of a proximal end ofthe second section.
 19. A catheter comprising: an inner liner definingan inner lumen; an outer jacket; a structural support member positionedbetween at least a portion of the inner liner and the outer jacket andcomprising a coil defining a plurality of turns, the plurality of turnscomprising a first turn and a second turn; and a support layercomprising an adhesive, wherein the support layer mechanically connectsthe structural support member to the inner liner and is positioned in aspace defined by a first surface of the first turn of the coil and asecond surface of the second turn of the coil such that the supportlayer extends from the first surface to the second surface, and whereinthe structural support member and the inner liner are not adhered to theouter jacket with adhesive.
 20. The catheter of claim 19, wherein theadhesive is a thermoset adhesive.
 21. The catheter of claim 19, whereinthe inner liner, the outer jacket, the coil member, and the supportlayer define an elongated body, and wherein the outer jacket comprises:a first section decreasing in durometer along a length of the firstsection in a direction towards a distal end of the elongated body; and asecond section more distal than the first section and including thedistal end of the elongated body, the second section having a higherdurometer than a distal portion of the first section, wherein the secondsection and the inner liner define a distal opening of the elongatedbody.
 22. The catheter of claim 21, wherein the structural supportmember extends along the first section of the outer jacket and does notextend along the second section.
 23. The catheter of claim 21, furthercomprising a radiopaque marker coupled to the elongated body, whereinthe elongated body distal to the radiopaque marker consists essentiallyof the inner liner and the outer jacket.
 24. A catheter comprising: aninner liner; an outer jacket; a coil member positioned between at leasta portion of the inner liner and the outer jacket, the coil memberdefining a plurality of turns comprising a first turn and a second turn;and an adhesive adhering the coil member to the inner liner, wherein theadhesive is positioned in a space defined by a first surface of thefirst turn of the coil member and a second surface of the second turn ofthe coil member such that the adhesive extends from the first surface tothe second surface, and wherein the coil member and the inner liner arenot adhered to the outer jacket with adhesive.